National Provider Identifier [NPI]: |
1598876245 |
Last Name Of The Provider |
FRICK |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
NP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 S LAKE PARK AVE |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
HOBART |
Zip Code Of The Provider |
463426790 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
303 |
Number Of Medicare Beneficiaries |
216 |
Total Submitted Charge Amount |
49370 |
Total Medicare Allowed Amount |
23317.5 |
Total Medicare Payment Amount |
18163.81 |
Total Medicare Standardized Payment Amount |
22514.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
303 |
Number Of Medicare Beneficiaries With Medical Services |
216 |
Total Medical Submitted Charge Amount |
49370 |
Total Medical Medicare Allowed Amount |
23317.5 |
Total Medical Medicare Payment Amount |
18163.81 |
Total Medical Medicare Standardized Payment Amount |
22514.82 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
197 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8826 |