National Provider Identifier [NPI]: |
1407133291 |
Last Name Of The Provider |
GIBSON |
First Name Of The Provider |
CHRISTY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3116 HIGHWAY 34 E |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWNAN |
Zip Code Of The Provider |
302651342 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
122 |
Number Of Medicare Beneficiaries |
62 |
Total Submitted Charge Amount |
4425.54 |
Total Medicare Allowed Amount |
3681.98 |
Total Medicare Payment Amount |
3314.58 |
Total Medicare Standardized Payment Amount |
4020.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
46 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
1852.54 |
Total Drug Medicare AllowedAmount |
1592.24 |
Total Drug Medicare PaymentAmount |
1560.32 |
Total Drug Medicare Standardized Payment Amount |
1560.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
76 |
Number Of Medicare Beneficiaries With Medical Services |
62 |
Total Medical Submitted Charge Amount |
2573 |
Total Medical Medicare Allowed Amount |
2089.74 |
Total Medical Medicare Payment Amount |
1754.26 |
Total Medical Medicare Standardized Payment Amount |
2460.27 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
24 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
0 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7985 |