| National Provider Identifier [NPI]: | 1225038987 |
| Last Name Of The Provider | RUCK |
| First Name Of The Provider | VETA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | CFNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 136 KISSANE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRIGHTON |
| Zip Code Of The Provider | 48116 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 484 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 62390 |
| Total Medicare Allowed Amount | 27998.94 |
| Total Medicare Payment Amount | 20237.7 |
| Total Medicare Standardized Payment Amount | 25045.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 199 |
| Total Drug Medicare AllowedAmount | 75.92 |
| Total Drug Medicare PaymentAmount | 71.18 |
| Total Drug Medicare Standardized Payment Amount | 71.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 465 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 62191 |
| Total Medical Medicare Allowed Amount | 27923.02 |
| Total Medical Medicare Payment Amount | 20166.52 |
| Total Medical Medicare Standardized Payment Amount | 24974.39 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 69 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 101 |
| 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 | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2436 |