National Provider Identifier [NPI]: |
1801236468 |
Last Name Of The Provider |
LEEDY |
First Name Of The Provider |
KARILYNN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4961 ROBERTS RD |
Street Address 2 Of The Provider |
MINUTECLINIC DIAGNOSTIC OF OHIO, LLC |
City Of The Provider |
HILLIARD |
Zip Code Of The Provider |
43026 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
175 |
Number Of Medicare Beneficiaries |
102 |
Total Submitted Charge Amount |
7571.44 |
Total Medicare Allowed Amount |
6829.35 |
Total Medicare Payment Amount |
5384.88 |
Total Medicare Standardized Payment Amount |
6338.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
56 |
Number Of Medicare Beneficiaries With Drug Services |
53 |
Total Drug Submitted ChargeAmount |
1746.44 |
Total Drug Medicare AllowedAmount |
1746.44 |
Total Drug Medicare PaymentAmount |
1711.5 |
Total Drug Medicare Standardized Payment Amount |
1711.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
119 |
Number Of Medicare Beneficiaries With Medical Services |
102 |
Total Medical Submitted Charge Amount |
5825 |
Total Medical Medicare Allowed Amount |
5082.91 |
Total Medical Medicare Payment Amount |
3673.38 |
Total Medical Medicare Standardized Payment Amount |
4626.74 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
43 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
|
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
19 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.888 |