National Provider Identifier [NPI]: |
1295984359 |
Last Name Of The Provider |
HURSH |
First Name Of The Provider |
MICHELE |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
211 N EDDY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH BEND |
Zip Code Of The Provider |
466172808 |
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 |
27 |
Number Of Services |
2004 |
Number Of Medicare Beneficiaries |
505 |
Total Submitted Charge Amount |
381396 |
Total Medicare Allowed Amount |
148324.02 |
Total Medicare Payment Amount |
115148.97 |
Total Medicare Standardized Payment Amount |
139696.38 |
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 |
27 |
Number Of Medical Services |
2004 |
Number Of Medicare Beneficiaries With Medical Services |
505 |
Total Medical Submitted Charge Amount |
381396 |
Total Medical Medicare Allowed Amount |
148324.02 |
Total Medical Medicare Payment Amount |
115148.97 |
Total Medical Medicare Standardized Payment Amount |
139696.38 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
147 |
Number Of Beneficiaries Age Greater 84 |
209 |
Number Of Female Beneficiaries |
316 |
Number Of Male Beneficiaries |
189 |
Number Of Non Hispanic White Beneficiaries |
449 |
Number Of Black or African American Beneficiaries |
43 |
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 |
322 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
183 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
47 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.1858 |