National Provider Identifier [NPI]: |
1265579700 |
Last Name Of The Provider |
PERMIN |
First Name Of The Provider |
CATHERINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1306 VERSAILLES RD |
Street Address 2 Of The Provider |
STE 120 |
City Of The Provider |
LEXINGTON |
Zip Code Of The Provider |
405041796 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
342 |
Number Of Medicare Beneficiaries |
161 |
Total Submitted Charge Amount |
44046 |
Total Medicare Allowed Amount |
17909.85 |
Total Medicare Payment Amount |
11493.03 |
Total Medicare Standardized Payment Amount |
15138.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
359 |
Total Drug Medicare AllowedAmount |
199.8 |
Total Drug Medicare PaymentAmount |
195.21 |
Total Drug Medicare Standardized Payment Amount |
195.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
330 |
Number Of Medicare Beneficiaries With Medical Services |
161 |
Total Medical Submitted Charge Amount |
43687 |
Total Medical Medicare Allowed Amount |
17710.05 |
Total Medical Medicare Payment Amount |
11297.82 |
Total Medical Medicare Standardized Payment Amount |
14943.62 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
106 |
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 |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3015 |