National Provider Identifier [NPI]: |
1750570156 |
Last Name Of The Provider |
BAXTER |
First Name Of The Provider |
TINA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
GNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
720 W 8TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANDERSON |
Zip Code Of The Provider |
460161206 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
3230 |
Number Of Medicare Beneficiaries |
648 |
Total Submitted Charge Amount |
334133 |
Total Medicare Allowed Amount |
238239.93 |
Total Medicare Payment Amount |
176627.24 |
Total Medicare Standardized Payment Amount |
219643.58 |
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 |
23 |
Number Of Medical Services |
3230 |
Number Of Medicare Beneficiaries With Medical Services |
648 |
Total Medical Submitted Charge Amount |
334133 |
Total Medical Medicare Allowed Amount |
238239.93 |
Total Medical Medicare Payment Amount |
176627.24 |
Total Medical Medicare Standardized Payment Amount |
219643.58 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
288 |
Number Of Female Beneficiaries |
424 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
619 |
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 |
315 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
333 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
65 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
31 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
32 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.086 |