National Provider Identifier [NPI]: |
1811232366 |
Last Name Of The Provider |
GAST |
First Name Of The Provider |
HEIDI |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 HAYES AVE |
Street Address 2 Of The Provider |
BUILDING G |
City Of The Provider |
SANDUSKY |
Zip Code Of The Provider |
448707248 |
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 |
14 |
Number Of Services |
259 |
Number Of Medicare Beneficiaries |
174 |
Total Submitted Charge Amount |
35953 |
Total Medicare Allowed Amount |
17151.85 |
Total Medicare Payment Amount |
13446.58 |
Total Medicare Standardized Payment Amount |
16063.4 |
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 |
14 |
Number Of Medical Services |
259 |
Number Of Medicare Beneficiaries With Medical Services |
174 |
Total Medical Submitted Charge Amount |
35953 |
Total Medical Medicare Allowed Amount |
17151.85 |
Total Medical Medicare Payment Amount |
13446.58 |
Total Medical Medicare Standardized Payment Amount |
16063.4 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
155 |
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 |
124 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
66 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
73 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.6588 |