National Provider Identifier [NPI]: |
1811000821 |
Last Name Of The Provider |
BRADFORD |
First Name Of The Provider |
MARNETTA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
665 CAREY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HANOVER TOWNSHIP |
Zip Code Of The Provider |
187065466 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
252 |
Number Of Medicare Beneficiaries |
72 |
Total Submitted Charge Amount |
26775 |
Total Medicare Allowed Amount |
13444.86 |
Total Medicare Payment Amount |
10352.47 |
Total Medicare Standardized Payment Amount |
12527.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
47 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
1995 |
Total Drug Medicare AllowedAmount |
720.14 |
Total Drug Medicare PaymentAmount |
686.45 |
Total Drug Medicare Standardized Payment Amount |
686.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
205 |
Number Of Medicare Beneficiaries With Medical Services |
72 |
Total Medical Submitted Charge Amount |
24780 |
Total Medical Medicare Allowed Amount |
12724.72 |
Total Medical Medicare Payment Amount |
9666.02 |
Total Medical Medicare Standardized Payment Amount |
11840.83 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
60 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
38 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8616 |