National Provider Identifier [NPI]: |
1770537425 |
Last Name Of The Provider |
CONLEY |
First Name Of The Provider |
NANCY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10415 DOUBLE R BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
RENO |
Zip Code Of The Provider |
895218905 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
454 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
51316.15 |
Total Medicare Allowed Amount |
37242.63 |
Total Medicare Payment Amount |
27085.76 |
Total Medicare Standardized Payment Amount |
27195.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
45 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1756 |
Total Drug Medicare AllowedAmount |
1248.5 |
Total Drug Medicare PaymentAmount |
1214.75 |
Total Drug Medicare Standardized Payment Amount |
1214.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
409 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
49560.15 |
Total Medical Medicare Allowed Amount |
35994.13 |
Total Medical Medicare Payment Amount |
25871.01 |
Total Medical Medicare Standardized Payment Amount |
25980.99 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
159 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
7 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
12 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
33 |
Percent Of With Ischemic Heart Disease |
12 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6373 |