National Provider Identifier [NPI]: |
1215188412 |
Last Name Of The Provider |
BAKER |
First Name Of The Provider |
JAMIE |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 LAKELAND HILLS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKELAND |
Zip Code Of The Provider |
338053019 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
948 |
Number Of Medicare Beneficiaries |
352 |
Total Submitted Charge Amount |
126991 |
Total Medicare Allowed Amount |
62275.67 |
Total Medicare Payment Amount |
45654 |
Total Medicare Standardized Payment Amount |
54739.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
103 |
Number Of Medicare Beneficiaries With Drug Services |
80 |
Total Drug Submitted ChargeAmount |
4370 |
Total Drug Medicare AllowedAmount |
2688.29 |
Total Drug Medicare PaymentAmount |
2595.96 |
Total Drug Medicare Standardized Payment Amount |
2595.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
845 |
Number Of Medicare Beneficiaries With Medical Services |
352 |
Total Medical Submitted Charge Amount |
122621 |
Total Medical Medicare Allowed Amount |
59587.38 |
Total Medical Medicare Payment Amount |
43058.04 |
Total Medical Medicare Standardized Payment Amount |
52143.79 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
325 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
331 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0619 |