National Provider Identifier [NPI]: |
1730107392 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
APRN, BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 MEDICAL CENTER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
COOKEVILLE |
Zip Code Of The Provider |
385014294 |
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 |
10 |
Number Of Services |
923 |
Number Of Medicare Beneficiaries |
482 |
Total Submitted Charge Amount |
142424 |
Total Medicare Allowed Amount |
39669.39 |
Total Medicare Payment Amount |
27542.71 |
Total Medicare Standardized Payment Amount |
35564.4 |
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 |
10 |
Number Of Medical Services |
923 |
Number Of Medicare Beneficiaries With Medical Services |
482 |
Total Medical Submitted Charge Amount |
142424 |
Total Medical Medicare Allowed Amount |
39669.39 |
Total Medical Medicare Payment Amount |
27542.71 |
Total Medical Medicare Standardized Payment Amount |
35564.4 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
464 |
Number Of Black or African American Beneficiaries |
|
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 |
370 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
36 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.8746 |