National Provider Identifier [NPI]: |
1952616997 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
CORICE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
ACNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
550 PEACHTREE ST NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303082208 |
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 |
11 |
Number Of Services |
652 |
Number Of Medicare Beneficiaries |
179 |
Total Submitted Charge Amount |
280692 |
Total Medicare Allowed Amount |
71982.45 |
Total Medicare Payment Amount |
56223.65 |
Total Medicare Standardized Payment Amount |
45872.93 |
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 |
11 |
Number Of Medical Services |
652 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
280692 |
Total Medical Medicare Allowed Amount |
71982.45 |
Total Medical Medicare Payment Amount |
56223.65 |
Total Medical Medicare Standardized Payment Amount |
45872.93 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
136 |
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 |
87 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
5.1284 |