National Provider Identifier [NPI]: |
1558423251 |
Last Name Of The Provider |
JENTSCH |
First Name Of The Provider |
PATRICIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12700 SOUTHFORK RD |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631283201 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
573 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
78196 |
Total Medicare Allowed Amount |
33167.71 |
Total Medicare Payment Amount |
22666.95 |
Total Medicare Standardized Payment Amount |
27764.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
93 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
1809 |
Total Drug Medicare AllowedAmount |
830.17 |
Total Drug Medicare PaymentAmount |
711.37 |
Total Drug Medicare Standardized Payment Amount |
711.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
480 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
76387 |
Total Medical Medicare Allowed Amount |
32337.54 |
Total Medical Medicare Payment Amount |
21955.58 |
Total Medical Medicare Standardized Payment Amount |
27053.52 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
85 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1474 |