National Provider Identifier [NPI]: |
1497837959 |
Last Name Of The Provider |
ARIDGE |
First Name Of The Provider |
DELLA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
RN, MSN, NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10004 KENNERLY RD |
Street Address 2 Of The Provider |
SUITE 330 A |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631282141 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
366 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
110895 |
Total Medicare Allowed Amount |
31607.64 |
Total Medicare Payment Amount |
23742.79 |
Total Medicare Standardized Payment Amount |
28673.18 |
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 |
34 |
Number Of Medical Services |
366 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
110895 |
Total Medical Medicare Allowed Amount |
31607.64 |
Total Medical Medicare Payment Amount |
23742.79 |
Total Medical Medicare Standardized Payment Amount |
28673.18 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
163 |
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 |
128 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
5.6569 |