National Provider Identifier [NPI]: |
1659569184 |
Last Name Of The Provider |
HANGGE |
First Name Of The Provider |
KRISTIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4430 E RAY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850446092 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
169 |
Number Of Medicare Beneficiaries |
96 |
Total Submitted Charge Amount |
7023.4 |
Total Medicare Allowed Amount |
6395.69 |
Total Medicare Payment Amount |
5282.75 |
Total Medicare Standardized Payment Amount |
6074.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
60 |
Number Of Medicare Beneficiaries With Drug Services |
56 |
Total Drug Submitted ChargeAmount |
1947.4 |
Total Drug Medicare AllowedAmount |
1947.4 |
Total Drug Medicare PaymentAmount |
1908.44 |
Total Drug Medicare Standardized Payment Amount |
1908.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
9 |
Number Of Medical Services |
109 |
Number Of Medicare Beneficiaries With Medical Services |
96 |
Total Medical Submitted Charge Amount |
5076 |
Total Medical Medicare Allowed Amount |
4448.29 |
Total Medical Medicare Payment Amount |
3374.31 |
Total Medical Medicare Standardized Payment Amount |
4166.07 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
37 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
11 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8473 |