National Provider Identifier [NPI]: |
1104805340 |
Last Name Of The Provider |
WOOD |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
RN CNP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
404 W FOUNTAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALBERT LEA |
Zip Code Of The Provider |
560072437 |
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 |
5 |
Number Of Services |
211 |
Number Of Medicare Beneficiaries |
102 |
Total Submitted Charge Amount |
41438 |
Total Medicare Allowed Amount |
13964.55 |
Total Medicare Payment Amount |
8991.82 |
Total Medicare Standardized Payment Amount |
11513.08 |
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 |
5 |
Number Of Medical Services |
211 |
Number Of Medicare Beneficiaries With Medical Services |
102 |
Total Medical Submitted Charge Amount |
41438 |
Total Medical Medicare Allowed Amount |
13964.55 |
Total Medical Medicare Payment Amount |
8991.82 |
Total Medical Medicare Standardized Payment Amount |
11513.08 |
Average Age Of Beneficiaries |
88 |
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 |
73 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
102 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
74 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.8011 |