National Provider Identifier [NPI]: |
1043304967 |
Last Name Of The Provider |
HENIGAN |
First Name Of The Provider |
TAMYRA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CFNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
573 N BRADLEY HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROGERS CITY |
Zip Code Of The Provider |
497791508 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
886 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
86872.36 |
Total Medicare Allowed Amount |
49114.05 |
Total Medicare Payment Amount |
30368.07 |
Total Medicare Standardized Payment Amount |
38903.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
81 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
2165.74 |
Total Drug Medicare AllowedAmount |
1312.64 |
Total Drug Medicare PaymentAmount |
1275.1 |
Total Drug Medicare Standardized Payment Amount |
1275.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
805 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
84706.62 |
Total Medical Medicare Allowed Amount |
47801.41 |
Total Medical Medicare Payment Amount |
29092.97 |
Total Medical Medicare Standardized Payment Amount |
37628.29 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
240 |
Number Of Male Beneficiaries |
74 |
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 |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.988 |