National Provider Identifier [NPI]: |
1336230499 |
Last Name Of The Provider |
HASLER |
First Name Of The Provider |
TRACY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
RN ANP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
509 HAMACHER ST |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
WATERLOO |
Zip Code Of The Provider |
622981592 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
122 |
Number Of Medicare Beneficiaries |
49 |
Total Submitted Charge Amount |
15904 |
Total Medicare Allowed Amount |
7592.07 |
Total Medicare Payment Amount |
5098.93 |
Total Medicare Standardized Payment Amount |
6107.04 |
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 |
7 |
Number Of Medical Services |
122 |
Number Of Medicare Beneficiaries With Medical Services |
49 |
Total Medical Submitted Charge Amount |
15904 |
Total Medical Medicare Allowed Amount |
7592.07 |
Total Medical Medicare Payment Amount |
5098.93 |
Total Medical Medicare Standardized Payment Amount |
6107.04 |
Average Age Of Beneficiaries |
85 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
12 |
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 |
19 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
51 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9213 |