National Provider Identifier [NPI]: |
1871706549 |
Last Name Of The Provider |
FURBER |
First Name Of The Provider |
SUSANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
F.N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3220 S JACKSON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDINBURG |
Zip Code Of The Provider |
785396666 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
442 |
Number Of Medicare Beneficiaries |
107 |
Total Submitted Charge Amount |
47335 |
Total Medicare Allowed Amount |
17381.39 |
Total Medicare Payment Amount |
12755.62 |
Total Medicare Standardized Payment Amount |
16141.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
2370 |
Total Drug Medicare AllowedAmount |
234.57 |
Total Drug Medicare PaymentAmount |
219.96 |
Total Drug Medicare Standardized Payment Amount |
219.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
390 |
Number Of Medicare Beneficiaries With Medical Services |
107 |
Total Medical Submitted Charge Amount |
44965 |
Total Medical Medicare Allowed Amount |
17146.82 |
Total Medical Medicare Payment Amount |
12535.66 |
Total Medical Medicare Standardized Payment Amount |
15921.29 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
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 |
30 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
36 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4007 |