National Provider Identifier [NPI]: |
1457432759 |
Last Name Of The Provider |
FEDYUK |
First Name Of The Provider |
OLGA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3209 S 23RD ST |
Street Address 2 Of The Provider |
STE 340 |
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984051602 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
1386 |
Number Of Medicare Beneficiaries |
499 |
Total Submitted Charge Amount |
157869.43 |
Total Medicare Allowed Amount |
66190.31 |
Total Medicare Payment Amount |
50197.8 |
Total Medicare Standardized Payment Amount |
59207.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
1386 |
Number Of Medicare Beneficiaries With Medical Services |
499 |
Total Medical Submitted Charge Amount |
157869.43 |
Total Medical Medicare Allowed Amount |
66190.31 |
Total Medical Medicare Payment Amount |
50197.8 |
Total Medical Medicare Standardized Payment Amount |
59207.9 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
205 |
Number Of Non Hispanic White Beneficiaries |
471 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
400 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6547 |