National Provider Identifier [NPI]: |
1518900356 |
Last Name Of The Provider |
EDWARDS |
First Name Of The Provider |
WENDY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
APNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8109 S 47TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRANKLIN |
Zip Code Of The Provider |
531328470 |
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 |
25 |
Number Of Services |
269 |
Number Of Medicare Beneficiaries |
156 |
Total Submitted Charge Amount |
11953.63 |
Total Medicare Allowed Amount |
8807.96 |
Total Medicare Payment Amount |
7228.09 |
Total Medicare Standardized Payment Amount |
8962.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
87 |
Number Of Medicare Beneficiaries With Drug Services |
80 |
Total Drug Submitted ChargeAmount |
3357.13 |
Total Drug Medicare AllowedAmount |
2779.98 |
Total Drug Medicare PaymentAmount |
2717.23 |
Total Drug Medicare Standardized Payment Amount |
2717.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
182 |
Number Of Medicare Beneficiaries With Medical Services |
156 |
Total Medical Submitted Charge Amount |
8596.5 |
Total Medical Medicare Allowed Amount |
6027.98 |
Total Medical Medicare Payment Amount |
4510.86 |
Total Medical Medicare Standardized Payment Amount |
6244.82 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
144 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.905 |