National Provider Identifier [NPI]: |
1689659203 |
Last Name Of The Provider |
THWEATT |
First Name Of The Provider |
ELAINE |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
275 W. HERNDON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLOVIS |
Zip Code Of The Provider |
93612 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
332 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
29589 |
Total Medicare Allowed Amount |
16387.99 |
Total Medicare Payment Amount |
11340.06 |
Total Medicare Standardized Payment Amount |
13044.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
43 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
919 |
Total Drug Medicare AllowedAmount |
89.66 |
Total Drug Medicare PaymentAmount |
69.76 |
Total Drug Medicare Standardized Payment Amount |
69.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
289 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
28670 |
Total Medical Medicare Allowed Amount |
16298.33 |
Total Medical Medicare Payment Amount |
11270.3 |
Total Medical Medicare Standardized Payment Amount |
12974.47 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
169 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
196 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.076 |