National Provider Identifier [NPI]: |
1164612834 |
Last Name Of The Provider |
SHERK |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3625 W 65TH ST |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
EDINA |
Zip Code Of The Provider |
554352106 |
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 |
23 |
Number Of Services |
595 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
83396.41 |
Total Medicare Allowed Amount |
36712.85 |
Total Medicare Payment Amount |
27314.38 |
Total Medicare Standardized Payment Amount |
33211.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
11 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
154 |
Total Drug Medicare AllowedAmount |
154 |
Total Drug Medicare PaymentAmount |
150.92 |
Total Drug Medicare Standardized Payment Amount |
150.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
584 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
83242.41 |
Total Medical Medicare Allowed Amount |
36558.85 |
Total Medical Medicare Payment Amount |
27163.46 |
Total Medical Medicare Standardized Payment Amount |
33060.73 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
239 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
233 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
67 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4591 |