National Provider Identifier [NPI]: |
1952338931 |
Last Name Of The Provider |
KLEIN |
First Name Of The Provider |
AMI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
APRN BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1414 W FAIR AVE |
Street Address 2 Of The Provider |
SUITE 334 |
City Of The Provider |
MARQUETTE |
Zip Code Of The Provider |
498552675 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
813 |
Number Of Medicare Beneficiaries |
764 |
Total Submitted Charge Amount |
103842 |
Total Medicare Allowed Amount |
70878.33 |
Total Medicare Payment Amount |
47896.91 |
Total Medicare Standardized Payment Amount |
60626.16 |
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 |
8 |
Number Of Medical Services |
813 |
Number Of Medicare Beneficiaries With Medical Services |
764 |
Total Medical Submitted Charge Amount |
103842 |
Total Medical Medicare Allowed Amount |
70878.33 |
Total Medical Medicare Payment Amount |
47896.91 |
Total Medical Medicare Standardized Payment Amount |
60626.16 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
325 |
Number Of Beneficiaries Age 75 to 84 |
291 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
269 |
Number Of Male Beneficiaries |
495 |
Number Of Non Hispanic White Beneficiaries |
718 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
23 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
692 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4441 |