National Provider Identifier [NPI]: |
1104022573 |
Last Name Of The Provider |
BARNEY |
First Name Of The Provider |
JACLYN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3500 TOWER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SUPERIOR |
Zip Code Of The Provider |
548805335 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
554 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
121035 |
Total Medicare Allowed Amount |
38023.33 |
Total Medicare Payment Amount |
25087.96 |
Total Medicare Standardized Payment Amount |
32351.53 |
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 |
11 |
Number Of Medical Services |
554 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
121035 |
Total Medical Medicare Allowed Amount |
38023.33 |
Total Medical Medicare Payment Amount |
25087.96 |
Total Medical Medicare Standardized Payment Amount |
32351.53 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
109 |
Number Of Male Beneficiaries |
56 |
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 |
38 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
52 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
27 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1468 |