National Provider Identifier [NPI]: |
1194791400 |
Last Name Of The Provider |
DUENAS |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MS FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
714 MAIN ST |
Street Address 2 Of The Provider |
SUITE 706A, BICKFORD HEALTH ASSOCIATES,PC |
City Of The Provider |
YARMOUTH PORT |
Zip Code Of The Provider |
026752000 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
928 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
89550 |
Total Medicare Allowed Amount |
42855.04 |
Total Medicare Payment Amount |
33737.62 |
Total Medicare Standardized Payment Amount |
38591.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
42 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
3465 |
Total Drug Medicare AllowedAmount |
1635.77 |
Total Drug Medicare PaymentAmount |
1591.84 |
Total Drug Medicare Standardized Payment Amount |
1591.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
886 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
86085 |
Total Medical Medicare Allowed Amount |
41219.27 |
Total Medical Medicare Payment Amount |
32145.78 |
Total Medical Medicare Standardized Payment Amount |
37000.13 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
42 |
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0511 |