National Provider Identifier [NPI]: |
1184889115 |
Last Name Of The Provider |
FRIEND |
First Name Of The Provider |
BRENDA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3183 W STATE ST |
Street Address 2 Of The Provider |
SUITE 1101 |
City Of The Provider |
BRISTOL |
Zip Code Of The Provider |
376201712 |
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 |
16 |
Number Of Services |
2274 |
Number Of Medicare Beneficiaries |
525 |
Total Submitted Charge Amount |
578977 |
Total Medicare Allowed Amount |
165023.28 |
Total Medicare Payment Amount |
114273.81 |
Total Medicare Standardized Payment Amount |
153002.16 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
359 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
268 |
Number Of Male Beneficiaries |
257 |
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 |
300 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
225 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2222 |