National Provider Identifier [NPI]: |
1780815985 |
Last Name Of The Provider |
CAMERON |
First Name Of The Provider |
JENNIFER |
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 |
2551 GREENWOOD RD |
Street Address 2 Of The Provider |
STE 220 |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711033981 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
160 |
Number Of Medicare Beneficiaries |
91 |
Total Submitted Charge Amount |
18500 |
Total Medicare Allowed Amount |
9501.07 |
Total Medicare Payment Amount |
7199.75 |
Total Medicare Standardized Payment Amount |
8877.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
673 |
Total Drug Medicare AllowedAmount |
336.8 |
Total Drug Medicare PaymentAmount |
306.43 |
Total Drug Medicare Standardized Payment Amount |
306.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
140 |
Number Of Medicare Beneficiaries With Medical Services |
91 |
Total Medical Submitted Charge Amount |
17827 |
Total Medical Medicare Allowed Amount |
9164.27 |
Total Medical Medicare Payment Amount |
6893.32 |
Total Medical Medicare Standardized Payment Amount |
8570.59 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
27 |
Number Of Non Hispanic White Beneficiaries |
70 |
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 |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.8595 |