National Provider Identifier [NPI]: |
1740595248 |
Last Name Of The Provider |
ATMORE |
First Name Of The Provider |
DENISER |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
NURSE PRACTITIONER |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5947 HIGHWAY 269 |
Street Address 2 Of The Provider |
|
City Of The Provider |
PARRISH |
Zip Code Of The Provider |
355803847 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
116 |
Number Of Medicare Beneficiaries |
54 |
Total Submitted Charge Amount |
4206.37 |
Total Medicare Allowed Amount |
1130.96 |
Total Medicare Payment Amount |
844.83 |
Total Medicare Standardized Payment Amount |
1088.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
1804 |
Total Drug Medicare AllowedAmount |
51.33 |
Total Drug Medicare PaymentAmount |
42.64 |
Total Drug Medicare Standardized Payment Amount |
42.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
64 |
Number Of Medicare Beneficiaries With Medical Services |
32 |
Total Medical Submitted Charge Amount |
2402.37 |
Total Medical Medicare Allowed Amount |
1079.63 |
Total Medical Medicare Payment Amount |
802.19 |
Total Medical Medicare Standardized Payment Amount |
1045.77 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
29 |
Number Of Male Beneficiaries |
25 |
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 |
20 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
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 |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1432 |