National Provider Identifier [NPI]: |
1043314271 |
Last Name Of The Provider |
DUTTON |
First Name Of The Provider |
DOROTHY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
FNP, CNM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
94125 4TH STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
GOLD BEACH |
Zip Code Of The Provider |
97444 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
642 |
Number Of Medicare Beneficiaries |
192 |
Total Submitted Charge Amount |
120050 |
Total Medicare Allowed Amount |
52135.62 |
Total Medicare Payment Amount |
33416.62 |
Total Medicare Standardized Payment Amount |
43687.97 |
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 |
18 |
Number Of Medical Services |
642 |
Number Of Medicare Beneficiaries With Medical Services |
192 |
Total Medical Submitted Charge Amount |
120050 |
Total Medical Medicare Allowed Amount |
52135.62 |
Total Medical Medicare Payment Amount |
33416.62 |
Total Medical Medicare Standardized Payment Amount |
43687.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
181 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
148 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8267 |