National Provider Identifier [NPI]: |
1972564755 |
Last Name Of The Provider |
GIBSON |
First Name Of The Provider |
FLORENCETTA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 WASHINGTON ST |
Street Address 2 Of The Provider |
SUITE 208 |
City Of The Provider |
MONROE |
Zip Code Of The Provider |
712016714 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Certified Clinical Nurse Specialist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
587 |
Number Of Medicare Beneficiaries |
65 |
Total Submitted Charge Amount |
87550 |
Total Medicare Allowed Amount |
43267.55 |
Total Medicare Payment Amount |
32166.15 |
Total Medicare Standardized Payment Amount |
39337.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
587 |
Number Of Medicare Beneficiaries With Medical Services |
65 |
Total Medical Submitted Charge Amount |
87550 |
Total Medical Medicare Allowed Amount |
43267.55 |
Total Medical Medicare Payment Amount |
32166.15 |
Total Medical Medicare Standardized Payment Amount |
39337.66 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
25 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
51 |
Number Of Male Beneficiaries |
14 |
Number Of Non Hispanic White Beneficiaries |
47 |
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 |
36 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
31 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.604 |