National Provider Identifier [NPI]: |
1033470422 |
Last Name Of The Provider |
PRINCE |
First Name Of The Provider |
JESSICA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8 PILGRIM HILL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PLYMOUTH |
Zip Code Of The Provider |
023606123 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
389 |
Number Of Medicare Beneficiaries |
231 |
Total Submitted Charge Amount |
18599.96 |
Total Medicare Allowed Amount |
16394.9 |
Total Medicare Payment Amount |
12939.4 |
Total Medicare Standardized Payment Amount |
14549.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
105 |
Number Of Medicare Beneficiaries With Drug Services |
97 |
Total Drug Submitted ChargeAmount |
3298.96 |
Total Drug Medicare AllowedAmount |
3269.46 |
Total Drug Medicare PaymentAmount |
3183.78 |
Total Drug Medicare Standardized Payment Amount |
3183.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
284 |
Number Of Medicare Beneficiaries With Medical Services |
231 |
Total Medical Submitted Charge Amount |
15301 |
Total Medical Medicare Allowed Amount |
13125.44 |
Total Medical Medicare Payment Amount |
9755.62 |
Total Medical Medicare Standardized Payment Amount |
11365.62 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
94 |
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 |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8087 |