National Provider Identifier [NPI]: |
1366679136 |
Last Name Of The Provider |
SUND |
First Name Of The Provider |
HEIDI |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 W OKLAHOMA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532154330 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
274 |
Number Of Medicare Beneficiaries |
214 |
Total Submitted Charge Amount |
113205 |
Total Medicare Allowed Amount |
22756.4 |
Total Medicare Payment Amount |
17599.34 |
Total Medicare Standardized Payment Amount |
21825.69 |
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 |
29 |
Number Of Medical Services |
274 |
Number Of Medicare Beneficiaries With Medical Services |
214 |
Total Medical Submitted Charge Amount |
113205 |
Total Medical Medicare Allowed Amount |
22756.4 |
Total Medical Medicare Payment Amount |
17599.34 |
Total Medical Medicare Standardized Payment Amount |
21825.69 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
95 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
147 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5742 |