National Provider Identifier [NPI]: |
1689618472 |
Last Name Of The Provider |
POWELL |
First Name Of The Provider |
ANGELA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
APRN BC FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1113 WASHINGTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
THOMSON |
Zip Code Of The Provider |
308247523 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
1205 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
70565.9 |
Total Medicare Allowed Amount |
35861.53 |
Total Medicare Payment Amount |
25510.28 |
Total Medicare Standardized Payment Amount |
32136.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
399 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
4609.9 |
Total Drug Medicare AllowedAmount |
672.42 |
Total Drug Medicare PaymentAmount |
587.04 |
Total Drug Medicare Standardized Payment Amount |
587.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
806 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
65956 |
Total Medical Medicare Allowed Amount |
35189.11 |
Total Medical Medicare Payment Amount |
24923.24 |
Total Medical Medicare Standardized Payment Amount |
31549.91 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
131 |
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 |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2113 |