National Provider Identifier [NPI]: |
1174745764 |
Last Name Of The Provider |
DODDS |
First Name Of The Provider |
VICTORIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 SE SALERNO RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
STUART |
Zip Code Of The Provider |
349976405 |
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 |
28 |
Number Of Services |
603 |
Number Of Medicare Beneficiaries |
216 |
Total Submitted Charge Amount |
78808 |
Total Medicare Allowed Amount |
34764.04 |
Total Medicare Payment Amount |
27980.48 |
Total Medicare Standardized Payment Amount |
30860.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
95 |
Number Of Medicare Beneficiaries With Drug Services |
78 |
Total Drug Submitted ChargeAmount |
3773 |
Total Drug Medicare AllowedAmount |
2140.67 |
Total Drug Medicare PaymentAmount |
2091 |
Total Drug Medicare Standardized Payment Amount |
2091 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
508 |
Number Of Medicare Beneficiaries With Medical Services |
216 |
Total Medical Submitted Charge Amount |
75035 |
Total Medical Medicare Allowed Amount |
32623.37 |
Total Medical Medicare Payment Amount |
25889.48 |
Total Medical Medicare Standardized Payment Amount |
28769.41 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
61 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.1736 |