National Provider Identifier [NPI]: |
1174747604 |
Last Name Of The Provider |
HALL |
First Name Of The Provider |
KARA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
APN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1330 CEDAR LN BLDG B SUITE 900 |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULLAHOMA |
Zip Code Of The Provider |
373881327 |
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 |
31 |
Number Of Services |
247 |
Number Of Medicare Beneficiaries |
93 |
Total Submitted Charge Amount |
18931 |
Total Medicare Allowed Amount |
11785.71 |
Total Medicare Payment Amount |
6653.13 |
Total Medicare Standardized Payment Amount |
9266.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
80 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
745 |
Total Drug Medicare AllowedAmount |
83.28 |
Total Drug Medicare PaymentAmount |
33.48 |
Total Drug Medicare Standardized Payment Amount |
33.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
167 |
Number Of Medicare Beneficiaries With Medical Services |
93 |
Total Medical Submitted Charge Amount |
18186 |
Total Medical Medicare Allowed Amount |
11702.43 |
Total Medical Medicare Payment Amount |
6619.65 |
Total Medical Medicare Standardized Payment Amount |
9233.21 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
31 |
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 |
71 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9015 |