National Provider Identifier [NPI]: |
1023068111 |
Last Name Of The Provider |
EHLERS |
First Name Of The Provider |
KIM |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
A.R.N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 LANGWORTHY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DUBUQUE |
Zip Code Of The Provider |
520017313 |
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 |
91 |
Number Of Services |
3156 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
121617.7 |
Total Medicare Allowed Amount |
48160.69 |
Total Medicare Payment Amount |
37210.03 |
Total Medicare Standardized Payment Amount |
46593.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
756 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
2698.75 |
Total Drug Medicare AllowedAmount |
2141.49 |
Total Drug Medicare PaymentAmount |
2010.49 |
Total Drug Medicare Standardized Payment Amount |
2010.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
83 |
Number Of Medical Services |
2400 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
118918.95 |
Total Medical Medicare Allowed Amount |
46019.2 |
Total Medical Medicare Payment Amount |
35199.54 |
Total Medical Medicare Standardized Payment Amount |
44582.77 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
65 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
38 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0826 |