National Provider Identifier [NPI]: |
1902111727 |
Last Name Of The Provider |
BAIR |
First Name Of The Provider |
DOROTHY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
260 POLARIS PKWY |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
WESTERVILLE |
Zip Code Of The Provider |
430828019 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
374 |
Number Of Medicare Beneficiaries |
146 |
Total Submitted Charge Amount |
33947 |
Total Medicare Allowed Amount |
15684.82 |
Total Medicare Payment Amount |
11303.08 |
Total Medicare Standardized Payment Amount |
14267.16 |
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 |
6 |
Number Of Medical Services |
374 |
Number Of Medicare Beneficiaries With Medical Services |
146 |
Total Medical Submitted Charge Amount |
33947 |
Total Medical Medicare Allowed Amount |
15684.82 |
Total Medical Medicare Payment Amount |
11303.08 |
Total Medical Medicare Standardized Payment Amount |
14267.16 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
63 |
Number Of Male Beneficiaries |
83 |
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
51 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7788 |