Medicare Facts for Dr. Nicole R. Sly, DC


National Provider Identifier [NPI]: 1174786800
Last Name Of The Provider SLY
First Name Of The Provider NICOLE
Middle Initial Of The Provider R
Credentials Of The Provider D.C., L.A.C.
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 263 WEST 4TH STREET
Street Address 2 Of The Provider
City Of The Provider RUSH CITY
Zip Code Of The Provider 55069
State Code Of The Provider MN
Country Code Of The Provider US
Provider Type Of The Provider Chiropractic
Medicare Participation Indicator Y
Number Of HCPCS 2
Number Of Services 199
Number Of Medicare Beneficiaries 31
Total Submitted Charge Amount 9950
Total Medicare Allowed Amount 5570.96
Total Medicare Payment Amount 3865.52
Total Medicare Standardized Payment Amount 4077.98
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 2
Number Of Medical Services 199
Number Of Medicare Beneficiaries With Medical Services 31
Total Medical Submitted Charge Amount 9950
Total Medical Medicare Allowed Amount 5570.96
Total Medical Medicare Payment Amount 3865.52
Total Medical Medicare Standardized Payment Amount 4077.98
Average Age Of Beneficiaries 67
Number Of Beneficiaries Age Less65
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84 12
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 19
Number Of Male Beneficiaries 12
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
Number Of Beneficiaries With Medicare Medicaid Entitlement
Percent Of With Atrial Fibrillation 0
Percent Of With Alzheimers Disease or Dementia 0
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression
Percent Of With Diabetes
Percent Of With Hyperlipidemia 48
Percent Of With Hypertension 58
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis 0
Percent Of With Rheumatoid Arthritis Osteoarthritis
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke 0
Average HCC Risk Score Of Beneficiaries 1.1505

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