National Provider Identifier [NPI]: |
1770567125 |
Last Name Of The Provider |
VOGELSANG |
First Name Of The Provider |
DEBRA |
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 |
1025 MARSH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANKATO |
Zip Code Of The Provider |
560014752 |
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 |
28 |
Number Of Services |
502 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
55503.7 |
Total Medicare Allowed Amount |
20812.96 |
Total Medicare Payment Amount |
14718.24 |
Total Medicare Standardized Payment Amount |
17875.38 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
65 |
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 |
108 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4986 |