National Provider Identifier [NPI]: |
1356669519 |
Last Name Of The Provider |
RODERICK |
First Name Of The Provider |
JUNE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9823 TULIP TREE CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOVELAND |
Zip Code Of The Provider |
451405597 |
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 |
8 |
Number Of Services |
2457 |
Number Of Medicare Beneficiaries |
299 |
Total Submitted Charge Amount |
338117 |
Total Medicare Allowed Amount |
155958.15 |
Total Medicare Payment Amount |
117850.13 |
Total Medicare Standardized Payment Amount |
146321.85 |
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 |
8 |
Number Of Medical Services |
2457 |
Number Of Medicare Beneficiaries With Medical Services |
299 |
Total Medical Submitted Charge Amount |
338117 |
Total Medical Medicare Allowed Amount |
155958.15 |
Total Medical Medicare Payment Amount |
117850.13 |
Total Medical Medicare Standardized Payment Amount |
146321.85 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
221 |
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 |
100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
199 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
55 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.8178 |