National Provider Identifier [NPI]: |
1821158494 |
Last Name Of The Provider |
OWEN |
First Name Of The Provider |
JANE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1265 UNION AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381043415 |
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 |
9 |
Number Of Services |
753 |
Number Of Medicare Beneficiaries |
372 |
Total Submitted Charge Amount |
138129.21 |
Total Medicare Allowed Amount |
62010.79 |
Total Medicare Payment Amount |
48386.7 |
Total Medicare Standardized Payment Amount |
58809.21 |
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 |
9 |
Number Of Medical Services |
753 |
Number Of Medicare Beneficiaries With Medical Services |
372 |
Total Medical Submitted Charge Amount |
138129.21 |
Total Medical Medicare Allowed Amount |
62010.79 |
Total Medical Medicare Payment Amount |
48386.7 |
Total Medical Medicare Standardized Payment Amount |
58809.21 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
130 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
158 |
Number Of Non Hispanic White Beneficiaries |
264 |
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 |
247 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
48 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
72 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.6296 |