National Provider Identifier [NPI]: |
1932275518 |
Last Name Of The Provider |
BOAZ |
First Name Of The Provider |
LESLEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1555 S LAYTON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532151924 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
148 |
Number Of Medicare Beneficiaries |
78 |
Total Submitted Charge Amount |
6970.46 |
Total Medicare Allowed Amount |
4921.27 |
Total Medicare Payment Amount |
4608.72 |
Total Medicare Standardized Payment Amount |
4788.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
69 |
Number Of Medicare Beneficiaries With Drug Services |
67 |
Total Drug Submitted ChargeAmount |
3140.46 |
Total Drug Medicare AllowedAmount |
2621.64 |
Total Drug Medicare PaymentAmount |
2569.04 |
Total Drug Medicare Standardized Payment Amount |
2569.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
3 |
Number Of Medical Services |
79 |
Number Of Medicare Beneficiaries With Medical Services |
77 |
Total Medical Submitted Charge Amount |
3830 |
Total Medical Medicare Allowed Amount |
2299.63 |
Total Medical Medicare Payment Amount |
2039.68 |
Total Medical Medicare Standardized Payment Amount |
2219.25 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
24 |
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 |
78 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8826 |