National Provider Identifier [NPI]: |
1215221429 |
Last Name Of The Provider |
GILKERSON |
First Name Of The Provider |
KRISTINE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 N OAK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARSHFIELD |
Zip Code Of The Provider |
544495703 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1022 |
Number Of Medicare Beneficiaries |
161 |
Total Submitted Charge Amount |
170780.92 |
Total Medicare Allowed Amount |
60069.62 |
Total Medicare Payment Amount |
44121.58 |
Total Medicare Standardized Payment Amount |
55774.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
176 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
2256.95 |
Total Drug Medicare AllowedAmount |
1057.72 |
Total Drug Medicare PaymentAmount |
863.22 |
Total Drug Medicare Standardized Payment Amount |
863.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
846 |
Number Of Medicare Beneficiaries With Medical Services |
161 |
Total Medical Submitted Charge Amount |
168523.97 |
Total Medical Medicare Allowed Amount |
59011.9 |
Total Medical Medicare Payment Amount |
43258.36 |
Total Medical Medicare Standardized Payment Amount |
54911.72 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
81 |
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 |
118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
53 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
72 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.1909 |