National Provider Identifier [NPI]: |
1376626218 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
DEE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18598 HIGHWAY 13 NORTH |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRANSON WEST |
Zip Code Of The Provider |
65737 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
133 |
Number Of Medicare Beneficiaries |
94 |
Total Submitted Charge Amount |
4844 |
Total Medicare Allowed Amount |
1292.04 |
Total Medicare Payment Amount |
924.3 |
Total Medicare Standardized Payment Amount |
1071.09 |
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 |
26 |
Number Of Medical Services |
133 |
Number Of Medicare Beneficiaries With Medical Services |
94 |
Total Medical Submitted Charge Amount |
4844 |
Total Medical Medicare Allowed Amount |
1292.04 |
Total Medical Medicare Payment Amount |
924.3 |
Total Medical Medicare Standardized Payment Amount |
1071.09 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
73 |
Number Of Male Beneficiaries |
21 |
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 |
78 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
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 |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8991 |