National Provider Identifier [NPI]: |
1861460222 |
Last Name Of The Provider |
WYATT |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2863 HIGHWAY 45 BYP |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
383053618 |
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 |
94 |
Number Of Services |
3079 |
Number Of Medicare Beneficiaries |
552 |
Total Submitted Charge Amount |
167854.26 |
Total Medicare Allowed Amount |
70055.61 |
Total Medicare Payment Amount |
53941.51 |
Total Medicare Standardized Payment Amount |
64770.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
530 |
Number Of Medicare Beneficiaries With Drug Services |
125 |
Total Drug Submitted ChargeAmount |
8963 |
Total Drug Medicare AllowedAmount |
4667.97 |
Total Drug Medicare PaymentAmount |
3847.14 |
Total Drug Medicare Standardized Payment Amount |
3847.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
78 |
Number Of Medical Services |
2549 |
Number Of Medicare Beneficiaries With Medical Services |
552 |
Total Medical Submitted Charge Amount |
158891.26 |
Total Medical Medicare Allowed Amount |
65387.64 |
Total Medical Medicare Payment Amount |
50094.37 |
Total Medical Medicare Standardized Payment Amount |
60923.69 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
256 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
177 |
Number Of Non Hispanic White Beneficiaries |
494 |
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 |
428 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1157 |