National Provider Identifier [NPI]: |
1750569638 |
Last Name Of The Provider |
CAWTHON |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
920 2ND AVE S |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554023318 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
163 |
Number Of Medicare Beneficiaries |
87 |
Total Submitted Charge Amount |
5253.42 |
Total Medicare Allowed Amount |
4831.88 |
Total Medicare Payment Amount |
4271.64 |
Total Medicare Standardized Payment Amount |
5403.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
70 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
2880.42 |
Total Drug Medicare AllowedAmount |
2511.08 |
Total Drug Medicare PaymentAmount |
2460.71 |
Total Drug Medicare Standardized Payment Amount |
2460.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
9 |
Number Of Medical Services |
93 |
Number Of Medicare Beneficiaries With Medical Services |
85 |
Total Medical Submitted Charge Amount |
2373 |
Total Medical Medicare Allowed Amount |
2320.8 |
Total Medical Medicare Payment Amount |
1810.93 |
Total Medical Medicare Standardized Payment Amount |
2942.57 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
49 |
Number Of Male Beneficiaries |
38 |
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 |
|
Percent Of With Alzheimers Disease or Dementia |
|
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 |
20 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7123 |