National Provider Identifier [NPI]: |
1972509339 |
Last Name Of The Provider |
BRUGGEMANN |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
40 N 64TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLEVILLE |
Zip Code Of The Provider |
622233808 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
2474 |
Number Of Medicare Beneficiaries |
473 |
Total Submitted Charge Amount |
165410 |
Total Medicare Allowed Amount |
150710.77 |
Total Medicare Payment Amount |
114974.2 |
Total Medicare Standardized Payment Amount |
140287.63 |
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 |
26 |
Number Of Medical Services |
2474 |
Number Of Medicare Beneficiaries With Medical Services |
473 |
Total Medical Submitted Charge Amount |
165410 |
Total Medical Medicare Allowed Amount |
150710.77 |
Total Medical Medicare Payment Amount |
114974.2 |
Total Medical Medicare Standardized Payment Amount |
140287.63 |
Average Age Of Beneficiaries |
84 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
257 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
442 |
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 |
237 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
236 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
73 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
59 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.3632 |