National Provider Identifier [NPI]: |
1659689529 |
Last Name Of The Provider |
KASLOW |
First Name Of The Provider |
JESSICA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
94 CONNECTICUT BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
EAST HARTFORD |
Zip Code Of The Provider |
061083013 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
485 |
Number Of Medicare Beneficiaries |
257 |
Total Submitted Charge Amount |
133973 |
Total Medicare Allowed Amount |
36127.71 |
Total Medicare Payment Amount |
26529.82 |
Total Medicare Standardized Payment Amount |
29546.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
1086 |
Total Drug Medicare AllowedAmount |
416.3 |
Total Drug Medicare PaymentAmount |
404.82 |
Total Drug Medicare Standardized Payment Amount |
404.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
466 |
Number Of Medicare Beneficiaries With Medical Services |
257 |
Total Medical Submitted Charge Amount |
132887 |
Total Medical Medicare Allowed Amount |
35711.41 |
Total Medical Medicare Payment Amount |
26125 |
Total Medical Medicare Standardized Payment Amount |
29141.19 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
176 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
148 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5238 |