National Provider Identifier [NPI]: |
1205114691 |
Last Name Of The Provider |
WERNER |
First Name Of The Provider |
CORINNA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
NP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2854 HIGHWAY 55 |
Street Address 2 Of The Provider |
SUITE 190 |
City Of The Provider |
EAGAN |
Zip Code Of The Provider |
551212156 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
12804 |
Number Of Medicare Beneficiaries |
78 |
Total Submitted Charge Amount |
500071 |
Total Medicare Allowed Amount |
341305.62 |
Total Medicare Payment Amount |
263107.75 |
Total Medicare Standardized Payment Amount |
265922.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
12491 |
Number Of Medicare Beneficiaries With Drug Services |
69 |
Total Drug Submitted ChargeAmount |
449595 |
Total Drug Medicare AllowedAmount |
319627.22 |
Total Drug Medicare PaymentAmount |
249046.2 |
Total Drug Medicare Standardized Payment Amount |
249046.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
9 |
Number Of Medical Services |
313 |
Number Of Medicare Beneficiaries With Medical Services |
78 |
Total Medical Submitted Charge Amount |
50476 |
Total Medical Medicare Allowed Amount |
21678.4 |
Total Medical Medicare Payment Amount |
14061.55 |
Total Medical Medicare Standardized Payment Amount |
16875.96 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
16 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
24 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
42 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2854 |