National Provider Identifier [NPI]: |
1831269901 |
Last Name Of The Provider |
CHAVEZ |
First Name Of The Provider |
BARBARA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 S LAKE PARK AVE |
Street Address 2 Of The Provider |
STE 1103 |
City Of The Provider |
HOBART |
Zip Code Of The Provider |
463426638 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
850 |
Number Of Medicare Beneficiaries |
158 |
Total Submitted Charge Amount |
176782 |
Total Medicare Allowed Amount |
32304.54 |
Total Medicare Payment Amount |
24841.48 |
Total Medicare Standardized Payment Amount |
30848.94 |
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 |
22 |
Number Of Medical Services |
850 |
Number Of Medicare Beneficiaries With Medical Services |
158 |
Total Medical Submitted Charge Amount |
176782 |
Total Medical Medicare Allowed Amount |
32304.54 |
Total Medical Medicare Payment Amount |
24841.48 |
Total Medical Medicare Standardized Payment Amount |
30848.94 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
137 |
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 |
131 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.6078 |