National Provider Identifier [NPI]: |
1821394859 |
Last Name Of The Provider |
JEAN-PIERRE |
First Name Of The Provider |
KARLENE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22 DEPOT HILL RD |
Street Address 2 Of The Provider |
CVS MINUTE CLINIC |
City Of The Provider |
SOUTHBURY |
Zip Code Of The Provider |
064882258 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
267 |
Number Of Medicare Beneficiaries |
188 |
Total Submitted Charge Amount |
33976.8 |
Total Medicare Allowed Amount |
13477.13 |
Total Medicare Payment Amount |
3981.87 |
Total Medicare Standardized Payment Amount |
5057.55 |
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 |
11 |
Number Of Medical Services |
267 |
Number Of Medicare Beneficiaries With Medical Services |
188 |
Total Medical Submitted Charge Amount |
33976.8 |
Total Medical Medicare Allowed Amount |
13477.13 |
Total Medical Medicare Payment Amount |
3981.87 |
Total Medical Medicare Standardized Payment Amount |
5057.55 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
32 |
Number Of Beneficiaries Age 75 to 84 |
14 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
149 |
Number Of Black or African American Beneficiaries |
16 |
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 |
43 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
145 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8037 |