National Provider Identifier [NPI]: |
1649380940 |
Last Name Of The Provider |
WINDHAM |
First Name Of The Provider |
BILLY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
415 S 28TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HATTIESBURG |
Zip Code Of The Provider |
394017246 |
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 |
28 |
Number Of Services |
1817 |
Number Of Medicare Beneficiaries |
330 |
Total Submitted Charge Amount |
299073 |
Total Medicare Allowed Amount |
112694.29 |
Total Medicare Payment Amount |
83750.67 |
Total Medicare Standardized Payment Amount |
94816.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
777 |
Number Of Medicare Beneficiaries With Drug Services |
177 |
Total Drug Submitted ChargeAmount |
111223 |
Total Drug Medicare AllowedAmount |
49633.05 |
Total Drug Medicare PaymentAmount |
37143.86 |
Total Drug Medicare Standardized Payment Amount |
37143.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
1040 |
Number Of Medicare Beneficiaries With Medical Services |
330 |
Total Medical Submitted Charge Amount |
187850 |
Total Medical Medicare Allowed Amount |
63061.24 |
Total Medical Medicare Payment Amount |
46606.81 |
Total Medical Medicare Standardized Payment Amount |
57673.05 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
200 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
246 |
Number Of Black or African American Beneficiaries |
84 |
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.4992 |