National Provider Identifier [NPI]: |
1649571662 |
Last Name Of The Provider |
SOLTIS |
First Name Of The Provider |
CARLEETA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
290 9TH ST NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BARBERTON |
Zip Code Of The Provider |
442033419 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
346 |
Number Of Medicare Beneficiaries |
71 |
Total Submitted Charge Amount |
22982 |
Total Medicare Allowed Amount |
14530.17 |
Total Medicare Payment Amount |
10896.29 |
Total Medicare Standardized Payment Amount |
13201.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
662 |
Total Drug Medicare AllowedAmount |
381.93 |
Total Drug Medicare PaymentAmount |
371.21 |
Total Drug Medicare Standardized Payment Amount |
371.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
323 |
Number Of Medicare Beneficiaries With Medical Services |
71 |
Total Medical Submitted Charge Amount |
22320 |
Total Medical Medicare Allowed Amount |
14148.24 |
Total Medical Medicare Payment Amount |
10525.08 |
Total Medical Medicare Standardized Payment Amount |
12829.87 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
12 |
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 |
47 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
21 |
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 |
1.0079 |