National Provider Identifier [NPI]: |
1538269469 |
Last Name Of The Provider |
NIEMIEC |
First Name Of The Provider |
MARICCA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7472 DOCS GROVE CIRCLE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORLANDO |
Zip Code Of The Provider |
32819 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
443 |
Number Of Medicare Beneficiaries |
103 |
Total Submitted Charge Amount |
20597.32 |
Total Medicare Allowed Amount |
14769.04 |
Total Medicare Payment Amount |
10713.54 |
Total Medicare Standardized Payment Amount |
11854.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
321 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
9306.82 |
Total Drug Medicare AllowedAmount |
8450.19 |
Total Drug Medicare PaymentAmount |
6747.46 |
Total Drug Medicare Standardized Payment Amount |
6747.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
122 |
Number Of Medicare Beneficiaries With Medical Services |
103 |
Total Medical Submitted Charge Amount |
11290.5 |
Total Medical Medicare Allowed Amount |
6318.85 |
Total Medical Medicare Payment Amount |
3966.08 |
Total Medical Medicare Standardized Payment Amount |
5107.02 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
67 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
90 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9428 |