National Provider Identifier [NPI]: |
1477586345 |
Last Name Of The Provider |
HOFFMANN |
First Name Of The Provider |
EMILY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 N HUMPHREYS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381202146 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
151 |
Number Of Medicare Beneficiaries |
69 |
Total Submitted Charge Amount |
12809.55 |
Total Medicare Allowed Amount |
4919.96 |
Total Medicare Payment Amount |
3431.23 |
Total Medicare Standardized Payment Amount |
4615.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
53 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
806 |
Total Drug Medicare AllowedAmount |
38.87 |
Total Drug Medicare PaymentAmount |
30.5 |
Total Drug Medicare Standardized Payment Amount |
30.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
98 |
Number Of Medicare Beneficiaries With Medical Services |
69 |
Total Medical Submitted Charge Amount |
12003.55 |
Total Medical Medicare Allowed Amount |
4881.09 |
Total Medical Medicare Payment Amount |
3400.73 |
Total Medical Medicare Standardized Payment Amount |
4585.15 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
28 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
43 |
Number Of Male Beneficiaries |
26 |
Number Of Non Hispanic White Beneficiaries |
40 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
43 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
28 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8914 |