National Provider Identifier [NPI]: |
1952640625 |
Last Name Of The Provider |
BERGMAN |
First Name Of The Provider |
NAOMI |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
895 UNION ST |
Street Address 2 Of The Provider |
SUITE 12 |
City Of The Provider |
BANGOR |
Zip Code Of The Provider |
044013053 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
529 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
67983 |
Total Medicare Allowed Amount |
31720.61 |
Total Medicare Payment Amount |
23331.48 |
Total Medicare Standardized Payment Amount |
29034.27 |
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 |
8 |
Number Of Medical Services |
529 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
67983 |
Total Medical Medicare Allowed Amount |
31720.61 |
Total Medical Medicare Payment Amount |
23331.48 |
Total Medical Medicare Standardized Payment Amount |
29034.27 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
62 |
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 |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
61 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.1052 |