National Provider Identifier [NPI]: |
1730436395 |
Last Name Of The Provider |
WOODSON |
First Name Of The Provider |
REGINA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4441 DUNLOE CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436156032 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
258 |
Number Of Medicare Beneficiaries |
140 |
Total Submitted Charge Amount |
13208 |
Total Medicare Allowed Amount |
9824.33 |
Total Medicare Payment Amount |
7206.69 |
Total Medicare Standardized Payment Amount |
8550.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
74 |
Number Of Medicare Beneficiaries With Drug Services |
61 |
Total Drug Submitted ChargeAmount |
1370 |
Total Drug Medicare AllowedAmount |
898.63 |
Total Drug Medicare PaymentAmount |
865.81 |
Total Drug Medicare Standardized Payment Amount |
865.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
184 |
Number Of Medicare Beneficiaries With Medical Services |
140 |
Total Medical Submitted Charge Amount |
11838 |
Total Medical Medicare Allowed Amount |
8925.7 |
Total Medical Medicare Payment Amount |
6340.88 |
Total Medical Medicare Standardized Payment Amount |
7684.24 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
125 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
11 |
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 |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7895 |