National Provider Identifier [NPI]: |
1851593974 |
Last Name Of The Provider |
NORDBLOM |
First Name Of The Provider |
LUMEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
985 SR 436 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CASSELBERRY |
Zip Code Of The Provider |
327075664 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
3058 |
Number Of Medicare Beneficiaries |
445 |
Total Submitted Charge Amount |
329125 |
Total Medicare Allowed Amount |
219097.97 |
Total Medicare Payment Amount |
170524.19 |
Total Medicare Standardized Payment Amount |
200549.85 |
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 |
3058 |
Number Of Medicare Beneficiaries With Medical Services |
445 |
Total Medical Submitted Charge Amount |
329125 |
Total Medical Medicare Allowed Amount |
219097.97 |
Total Medical Medicare Payment Amount |
170524.19 |
Total Medical Medicare Standardized Payment Amount |
200549.85 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
179 |
Number Of Female Beneficiaries |
293 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
347 |
Number Of Black or African American Beneficiaries |
62 |
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 |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
240 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
66 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.4602 |