National Provider Identifier [NPI]: |
1497056345 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
JUNECIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2300 DULANEY VALLEY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TIMONIUM |
Zip Code Of The Provider |
210932739 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
677 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
118412.36 |
Total Medicare Allowed Amount |
70776.85 |
Total Medicare Payment Amount |
54829.79 |
Total Medicare Standardized Payment Amount |
60535.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
507.55 |
Total Drug Medicare AllowedAmount |
378.15 |
Total Drug Medicare PaymentAmount |
370.64 |
Total Drug Medicare Standardized Payment Amount |
370.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
641 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
117904.81 |
Total Medical Medicare Allowed Amount |
70398.7 |
Total Medical Medicare Payment Amount |
54459.15 |
Total Medical Medicare Standardized Payment Amount |
60164.58 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
172 |
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 |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
60 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0185 |