National Provider Identifier [NPI]: |
1871923086 |
Last Name Of The Provider |
MEDVECZ |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1136 WESTOWNE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEENAH |
Zip Code Of The Provider |
549562175 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
255 |
Number Of Medicare Beneficiaries |
73 |
Total Submitted Charge Amount |
28087.8 |
Total Medicare Allowed Amount |
7902.04 |
Total Medicare Payment Amount |
6173.51 |
Total Medicare Standardized Payment Amount |
6485.89 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
28 |
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 |
49 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
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Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
42 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
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Percent Of With Alzheimers Disease or Dementia |
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Percent Of With Asthma |
18 |
Percent Of With Cancer |
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Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
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Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.472 |