National Provider Identifier [NPI]: |
1184768137 |
Last Name Of The Provider |
SHOCKLEY |
First Name Of The Provider |
CASSANDARA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
APRN, BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3355 RIVERBEND DR., STE 500 |
Street Address 2 Of The Provider |
EUGENE GASTROENTEROLOGY CONSULTANTS, P.C. |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
974778800 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
133 |
Number Of Medicare Beneficiaries |
131 |
Total Submitted Charge Amount |
59192 |
Total Medicare Allowed Amount |
17337.41 |
Total Medicare Payment Amount |
12286.66 |
Total Medicare Standardized Payment Amount |
15501.44 |
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 |
8 |
Number Of Medical Services |
133 |
Number Of Medicare Beneficiaries With Medical Services |
131 |
Total Medical Submitted Charge Amount |
59192 |
Total Medical Medicare Allowed Amount |
17337.41 |
Total Medical Medicare Payment Amount |
12286.66 |
Total Medical Medicare Standardized Payment Amount |
15501.44 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
120 |
Number Of Black or African American Beneficiaries |
0 |
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 |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1444 |