National Provider Identifier [NPI]: |
1457631053 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
FELICIA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1414 HOSPITAL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENVILLE |
Zip Code Of The Provider |
38701 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
278 |
Number Of Medicare Beneficiaries |
94 |
Total Submitted Charge Amount |
6648.96 |
Total Medicare Allowed Amount |
2201.38 |
Total Medicare Payment Amount |
1378 |
Total Medicare Standardized Payment Amount |
1547.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
104 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
1833.56 |
Total Drug Medicare AllowedAmount |
93.6 |
Total Drug Medicare PaymentAmount |
41.05 |
Total Drug Medicare Standardized Payment Amount |
41.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
174 |
Number Of Medicare Beneficiaries With Medical Services |
93 |
Total Medical Submitted Charge Amount |
4815.4 |
Total Medical Medicare Allowed Amount |
2107.78 |
Total Medical Medicare Payment Amount |
1336.95 |
Total Medical Medicare Standardized Payment Amount |
1506.32 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
63 |
Number Of Male Beneficiaries |
31 |
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 |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
0 |
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
16 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.7765 |