National Provider Identifier [NPI]: |
1023398971 |
Last Name Of The Provider |
GRANGAARD |
First Name Of The Provider |
KATHLEEN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
105 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WAUKON |
Zip Code Of The Provider |
521721735 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
240 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
32256.5 |
Total Medicare Allowed Amount |
10199.63 |
Total Medicare Payment Amount |
6884.98 |
Total Medicare Standardized Payment Amount |
8745.68 |
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 |
240 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
32256.5 |
Total Medical Medicare Allowed Amount |
10199.63 |
Total Medical Medicare Payment Amount |
6884.98 |
Total Medical Medicare Standardized Payment Amount |
8745.68 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
95 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0467 |