National Provider Identifier [NPI]: |
1841205606 |
Last Name Of The Provider |
MENKE |
First Name Of The Provider |
TRISHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3300 OAKDALE AVE N |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
ROBBINSDALE |
Zip Code Of The Provider |
554222926 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
322 |
Number Of Medicare Beneficiaries |
159 |
Total Submitted Charge Amount |
61649 |
Total Medicare Allowed Amount |
20030.06 |
Total Medicare Payment Amount |
15109.62 |
Total Medicare Standardized Payment Amount |
18831.17 |
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 |
12 |
Number Of Medical Services |
322 |
Number Of Medicare Beneficiaries With Medical Services |
159 |
Total Medical Submitted Charge Amount |
61649 |
Total Medical Medicare Allowed Amount |
20030.06 |
Total Medical Medicare Payment Amount |
15109.62 |
Total Medical Medicare Standardized Payment Amount |
18831.17 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
125 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
44 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.0353 |