National Provider Identifier [NPI]: |
1649528993 |
Last Name Of The Provider |
WHEELOCK |
First Name Of The Provider |
COURTNEY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
FNP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2825 EAST BARNETT RD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEDFORD |
Zip Code Of The Provider |
975048304 |
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 |
15 |
Number Of Services |
219 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
105105.59 |
Total Medicare Allowed Amount |
12144.33 |
Total Medicare Payment Amount |
7697.72 |
Total Medicare Standardized Payment Amount |
9673.5 |
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 |
15 |
Number Of Medical Services |
219 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
105105.59 |
Total Medical Medicare Allowed Amount |
12144.33 |
Total Medical Medicare Payment Amount |
7697.72 |
Total Medical Medicare Standardized Payment Amount |
9673.5 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
96 |
Number Of Male Beneficiaries |
95 |
Number Of Non Hispanic White Beneficiaries |
167 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
79 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1958 |