National Provider Identifier [NPI]: |
1932413762 |
Last Name Of The Provider |
DRIGGERS |
First Name Of The Provider |
BENDAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1710 14TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MERIDIAN |
Zip Code Of The Provider |
393014140 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
150 |
Number Of Medicare Beneficiaries |
37 |
Total Submitted Charge Amount |
10809 |
Total Medicare Allowed Amount |
6137.49 |
Total Medicare Payment Amount |
4818.46 |
Total Medicare Standardized Payment Amount |
5872.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
72 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
1233 |
Total Drug Medicare AllowedAmount |
428.19 |
Total Drug Medicare PaymentAmount |
409.93 |
Total Drug Medicare Standardized Payment Amount |
409.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
78 |
Number Of Medicare Beneficiaries With Medical Services |
37 |
Total Medical Submitted Charge Amount |
9576 |
Total Medical Medicare Allowed Amount |
5709.3 |
Total Medical Medicare Payment Amount |
4408.53 |
Total Medical Medicare Standardized Payment Amount |
5462.56 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
24 |
Number Of Male Beneficiaries |
13 |
Number Of Non Hispanic White Beneficiaries |
22 |
Number Of Black or African American Beneficiaries |
15 |
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 |
16 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
46 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3324 |