National Provider Identifier [NPI]: |
1972551414 |
Last Name Of The Provider |
MARSHALL |
First Name Of The Provider |
JILL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
205 N EAST AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
492011753 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
549 |
Number Of Medicare Beneficiaries |
336 |
Total Submitted Charge Amount |
110560 |
Total Medicare Allowed Amount |
42288.68 |
Total Medicare Payment Amount |
30506.95 |
Total Medicare Standardized Payment Amount |
38019.95 |
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 |
11 |
Number Of Medical Services |
549 |
Number Of Medicare Beneficiaries With Medical Services |
336 |
Total Medical Submitted Charge Amount |
110560 |
Total Medical Medicare Allowed Amount |
42288.68 |
Total Medical Medicare Payment Amount |
30506.95 |
Total Medical Medicare Standardized Payment Amount |
38019.95 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
152 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
207 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
304 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4682 |