National Provider Identifier [NPI]: |
1841286671 |
Last Name Of The Provider |
GAUGHAN |
First Name Of The Provider |
DENESE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1838 GREENE TREE RD |
Street Address 2 Of The Provider |
STE 400 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212086391 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
1157 |
Number Of Medicare Beneficiaries |
596 |
Total Submitted Charge Amount |
181869 |
Total Medicare Allowed Amount |
77173.69 |
Total Medicare Payment Amount |
59420.53 |
Total Medicare Standardized Payment Amount |
66975.41 |
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 |
8 |
Number Of Medical Services |
1157 |
Number Of Medicare Beneficiaries With Medical Services |
596 |
Total Medical Submitted Charge Amount |
181869 |
Total Medical Medicare Allowed Amount |
77173.69 |
Total Medical Medicare Payment Amount |
59420.53 |
Total Medical Medicare Standardized Payment Amount |
66975.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
129 |
Number Of Female Beneficiaries |
388 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
287 |
Number Of Black or African American Beneficiaries |
291 |
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 |
428 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.4721 |