National Provider Identifier [NPI]: |
1417386871 |
Last Name Of The Provider |
BAUER |
First Name Of The Provider |
ANNELIESE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
APNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3111 GUNDERSEN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ONALASKA |
Zip Code Of The Provider |
546508447 |
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 |
9 |
Number Of Services |
201 |
Number Of Medicare Beneficiaries |
138 |
Total Submitted Charge Amount |
20402.63 |
Total Medicare Allowed Amount |
11091.68 |
Total Medicare Payment Amount |
8373.04 |
Total Medicare Standardized Payment Amount |
10439.43 |
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 |
9 |
Number Of Medical Services |
201 |
Number Of Medicare Beneficiaries With Medical Services |
138 |
Total Medical Submitted Charge Amount |
20402.63 |
Total Medical Medicare Allowed Amount |
11091.68 |
Total Medical Medicare Payment Amount |
8373.04 |
Total Medical Medicare Standardized Payment Amount |
10439.43 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
36 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.241 |