National Provider Identifier [NPI]: |
1184895419 |
Last Name Of The Provider |
HOWARD |
First Name Of The Provider |
COURTNEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
120 SAINT JOHNS COMMONS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322594057 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
282 |
Number Of Medicare Beneficiaries |
159 |
Total Submitted Charge Amount |
11105.98 |
Total Medicare Allowed Amount |
10352.82 |
Total Medicare Payment Amount |
8295.58 |
Total Medicare Standardized Payment Amount |
9616.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
103 |
Number Of Medicare Beneficiaries With Drug Services |
98 |
Total Drug Submitted ChargeAmount |
3059.98 |
Total Drug Medicare AllowedAmount |
3059.98 |
Total Drug Medicare PaymentAmount |
2962.32 |
Total Drug Medicare Standardized Payment Amount |
2962.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
179 |
Number Of Medicare Beneficiaries With Medical Services |
157 |
Total Medical Submitted Charge Amount |
8046 |
Total Medical Medicare Allowed Amount |
7292.84 |
Total Medical Medicare Payment Amount |
5333.26 |
Total Medical Medicare Standardized Payment Amount |
6654.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
146 |
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 |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
8 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7685 |