National Provider Identifier [NPI]: |
1710104328 |
Last Name Of The Provider |
TUCCO |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
920 2ND AVE S |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554023318 |
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 |
17 |
Number Of Services |
240 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
9808.18 |
Total Medicare Allowed Amount |
9141.59 |
Total Medicare Payment Amount |
7343.27 |
Total Medicare Standardized Payment Amount |
8182.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
83 |
Number Of Medicare Beneficiaries With Drug Services |
79 |
Total Drug Submitted ChargeAmount |
2378.18 |
Total Drug Medicare AllowedAmount |
2378.18 |
Total Drug Medicare PaymentAmount |
2269.66 |
Total Drug Medicare Standardized Payment Amount |
2269.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
157 |
Number Of Medicare Beneficiaries With Medical Services |
122 |
Total Medical Submitted Charge Amount |
7430 |
Total Medical Medicare Allowed Amount |
6763.41 |
Total Medical Medicare Payment Amount |
5073.61 |
Total Medical Medicare Standardized Payment Amount |
5912.66 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
40 |
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 |
110 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
17 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8204 |