National Provider Identifier [NPI]: |
1114988706 |
Last Name Of The Provider |
EDDY |
First Name Of The Provider |
NATALIE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
601 GATEWAY BLVD N |
Street Address 2 Of The Provider |
#A |
City Of The Provider |
CHESTERTON |
Zip Code Of The Provider |
463049658 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
9832 |
Number Of Medicare Beneficiaries |
758 |
Total Submitted Charge Amount |
1048846 |
Total Medicare Allowed Amount |
266645.22 |
Total Medicare Payment Amount |
201059.48 |
Total Medicare Standardized Payment Amount |
229281.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
7463 |
Number Of Medicare Beneficiaries With Drug Services |
106 |
Total Drug Submitted ChargeAmount |
189936 |
Total Drug Medicare AllowedAmount |
107084.73 |
Total Drug Medicare PaymentAmount |
83076.11 |
Total Drug Medicare Standardized Payment Amount |
83076.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
2369 |
Number Of Medicare Beneficiaries With Medical Services |
757 |
Total Medical Submitted Charge Amount |
858910 |
Total Medical Medicare Allowed Amount |
159560.49 |
Total Medical Medicare Payment Amount |
117983.37 |
Total Medical Medicare Standardized Payment Amount |
146205.09 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
357 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
497 |
Number Of Male Beneficiaries |
261 |
Number Of Non Hispanic White Beneficiaries |
710 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
682 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
36 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1388 |