National Provider Identifier [NPI]: |
1851670343 |
Last Name Of The Provider |
BEAUMONT |
First Name Of The Provider |
BERNADETTE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2901 W KINNICKINNIC RIVER PKWY |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532153677 |
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 |
7 |
Number Of Services |
636 |
Number Of Medicare Beneficiaries |
250 |
Total Submitted Charge Amount |
85738 |
Total Medicare Allowed Amount |
41623.43 |
Total Medicare Payment Amount |
32594.77 |
Total Medicare Standardized Payment Amount |
39517.97 |
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 |
7 |
Number Of Medical Services |
636 |
Number Of Medicare Beneficiaries With Medical Services |
250 |
Total Medical Submitted Charge Amount |
85738 |
Total Medical Medicare Allowed Amount |
41623.43 |
Total Medical Medicare Payment Amount |
32594.77 |
Total Medical Medicare Standardized Payment Amount |
39517.97 |
Average Age Of Beneficiaries |
84 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
185 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
232 |
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 |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8874 |