National Provider Identifier [NPI]: |
1609175512 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
CAROLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
301 MED TECH PKWY STE 240 |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOHNSON CITY |
Zip Code Of The Provider |
376042364 |
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 |
25 |
Number Of Services |
1640 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
226565 |
Total Medicare Allowed Amount |
109789.81 |
Total Medicare Payment Amount |
85164.86 |
Total Medicare Standardized Payment Amount |
105813.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
1640 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
226565 |
Total Medical Medicare Allowed Amount |
109789.81 |
Total Medical Medicare Payment Amount |
85164.86 |
Total Medical Medicare Standardized Payment Amount |
105813.11 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
304 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
473 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
388 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.9558 |