National Provider Identifier [NPI]: |
1760639926 |
Last Name Of The Provider |
POUNCY |
First Name Of The Provider |
DAWDA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4301 N. MACARTHUR BLVD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
IRVING |
Zip Code Of The Provider |
75038 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
3771 |
Number Of Medicare Beneficiaries |
25 |
Total Submitted Charge Amount |
279101.42 |
Total Medicare Allowed Amount |
105241.82 |
Total Medicare Payment Amount |
82509.59 |
Total Medicare Standardized Payment Amount |
83407.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
3707 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
237657.32 |
Total Drug Medicare AllowedAmount |
100706.98 |
Total Drug Medicare PaymentAmount |
78954.23 |
Total Drug Medicare Standardized Payment Amount |
78954.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
3 |
Number Of Medical Services |
64 |
Number Of Medicare Beneficiaries With Medical Services |
25 |
Total Medical Submitted Charge Amount |
41444.1 |
Total Medical Medicare Allowed Amount |
4534.84 |
Total Medical Medicare Payment Amount |
3555.36 |
Total Medical Medicare Standardized Payment Amount |
4453.7 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
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 |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9778 |