National Provider Identifier [NPI]: |
1568489011 |
Last Name Of The Provider |
LEMAY |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9137 MIDDLEBROOK PIKE |
Street Address 2 Of The Provider |
INSIDE CVS |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379231425 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
217 |
Number Of Medicare Beneficiaries |
114 |
Total Submitted Charge Amount |
8719.36 |
Total Medicare Allowed Amount |
7489.93 |
Total Medicare Payment Amount |
5556.54 |
Total Medicare Standardized Payment Amount |
6637.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
64 |
Number Of Medicare Beneficiaries With Drug Services |
64 |
Total Drug Submitted ChargeAmount |
1880.36 |
Total Drug Medicare AllowedAmount |
1880.36 |
Total Drug Medicare PaymentAmount |
1812.37 |
Total Drug Medicare Standardized Payment Amount |
1812.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
153 |
Number Of Medicare Beneficiaries With Medical Services |
114 |
Total Medical Submitted Charge Amount |
6839 |
Total Medical Medicare Allowed Amount |
5609.57 |
Total Medical Medicare Payment Amount |
3744.17 |
Total Medical Medicare Standardized Payment Amount |
4825.02 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
55 |
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 |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7016 |