National Provider Identifier [NPI]: |
1275884454 |
Last Name Of The Provider |
MCCOLLUM |
First Name Of The Provider |
KARYN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
221 MICHIGAN ST NE |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495032543 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
748 |
Number Of Medicare Beneficiaries |
368 |
Total Submitted Charge Amount |
85916 |
Total Medicare Allowed Amount |
39557.38 |
Total Medicare Payment Amount |
30543.09 |
Total Medicare Standardized Payment Amount |
36740.61 |
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 |
21 |
Number Of Medical Services |
748 |
Number Of Medicare Beneficiaries With Medical Services |
368 |
Total Medical Submitted Charge Amount |
85916 |
Total Medical Medicare Allowed Amount |
39557.38 |
Total Medical Medicare Payment Amount |
30543.09 |
Total Medical Medicare Standardized Payment Amount |
36740.61 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
190 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
311 |
Number Of Black or African American Beneficiaries |
43 |
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 |
192 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
176 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
3.4479 |