National Provider Identifier [NPI]: |
1629047071 |
Last Name Of The Provider |
DUNBAR |
First Name Of The Provider |
CLAIRE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2 ESSEX CENTER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEABODY |
Zip Code Of The Provider |
019602902 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
760 |
Number Of Medicare Beneficiaries |
110 |
Total Submitted Charge Amount |
56929 |
Total Medicare Allowed Amount |
38793.54 |
Total Medicare Payment Amount |
28773.1 |
Total Medicare Standardized Payment Amount |
32895.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
1179 |
Total Drug Medicare AllowedAmount |
743.99 |
Total Drug Medicare PaymentAmount |
729.07 |
Total Drug Medicare Standardized Payment Amount |
729.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
741 |
Number Of Medicare Beneficiaries With Medical Services |
110 |
Total Medical Submitted Charge Amount |
55750 |
Total Medical Medicare Allowed Amount |
38049.55 |
Total Medical Medicare Payment Amount |
28044.03 |
Total Medical Medicare Standardized Payment Amount |
32166.47 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
40 |
Number Of Non Hispanic White Beneficiaries |
95 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.468 |