National Provider Identifier [NPI]: |
1417262890 |
Last Name Of The Provider |
LYLES |
First Name Of The Provider |
DANA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 E UNION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENVILLE |
Zip Code Of The Provider |
387033246 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
124 |
Number Of Services |
4712 |
Number Of Medicare Beneficiaries |
358 |
Total Submitted Charge Amount |
159904 |
Total Medicare Allowed Amount |
79036.35 |
Total Medicare Payment Amount |
56453.63 |
Total Medicare Standardized Payment Amount |
72140.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
1516 |
Number Of Medicare Beneficiaries With Drug Services |
230 |
Total Drug Submitted ChargeAmount |
19136 |
Total Drug Medicare AllowedAmount |
2684.99 |
Total Drug Medicare PaymentAmount |
1822.85 |
Total Drug Medicare Standardized Payment Amount |
1822.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
107 |
Number Of Medical Services |
3196 |
Number Of Medicare Beneficiaries With Medical Services |
358 |
Total Medical Submitted Charge Amount |
140768 |
Total Medical Medicare Allowed Amount |
76351.36 |
Total Medical Medicare Payment Amount |
54630.78 |
Total Medical Medicare Standardized Payment Amount |
70317.93 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
213 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
245 |
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 |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.7743 |