National Provider Identifier [NPI]: |
1003881194 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
KAREN |
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 |
4765 OGLETOWN STANTON RD |
Street Address 2 Of The Provider |
SUITE 1E20 |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197138003 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
143 |
Number Of Medicare Beneficiaries |
133 |
Total Submitted Charge Amount |
27295 |
Total Medicare Allowed Amount |
12236.79 |
Total Medicare Payment Amount |
9030.14 |
Total Medicare Standardized Payment Amount |
10549.26 |
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 |
9 |
Number Of Medical Services |
143 |
Number Of Medicare Beneficiaries With Medical Services |
133 |
Total Medical Submitted Charge Amount |
27295 |
Total Medical Medicare Allowed Amount |
12236.79 |
Total Medical Medicare Payment Amount |
9030.14 |
Total Medical Medicare Standardized Payment Amount |
10549.26 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
105 |
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 |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3607 |