National Provider Identifier [NPI]: |
1104019165 |
Last Name Of The Provider |
SOSTRE |
First Name Of The Provider |
MARIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 WASHINGTON AVE N |
Street Address 2 Of The Provider |
SUITE 5000 |
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554011377 |
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 |
20 |
Number Of Services |
410 |
Number Of Medicare Beneficiaries |
93 |
Total Submitted Charge Amount |
11057.07 |
Total Medicare Allowed Amount |
9612.59 |
Total Medicare Payment Amount |
7523.56 |
Total Medicare Standardized Payment Amount |
8614.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
290 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
5665.3 |
Total Drug Medicare AllowedAmount |
5191.07 |
Total Drug Medicare PaymentAmount |
4409.17 |
Total Drug Medicare Standardized Payment Amount |
4409.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
120 |
Number Of Medicare Beneficiaries With Medical Services |
93 |
Total Medical Submitted Charge Amount |
5391.77 |
Total Medical Medicare Allowed Amount |
4421.52 |
Total Medical Medicare Payment Amount |
3114.39 |
Total Medical Medicare Standardized Payment Amount |
4205.8 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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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 |
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Percent Of With Cancer |
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Percent Of With Heart Failure |
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Percent Of With Chronic Kidney Disease |
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Percent Of With Chronic Obstructive Pulmonary Disease |
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Percent Of With Depression |
|
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
0.7357 |