National Provider Identifier [NPI]: |
1972875516 |
Last Name Of The Provider |
CEPPARULO |
First Name Of The Provider |
KATE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
620 SKYLINE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
383013923 |
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 |
12 |
Number Of Services |
188 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
72925 |
Total Medicare Allowed Amount |
17138.22 |
Total Medicare Payment Amount |
12238.76 |
Total Medicare Standardized Payment Amount |
15593.75 |
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 |
12 |
Number Of Medical Services |
188 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
72925 |
Total Medical Medicare Allowed Amount |
17138.22 |
Total Medical Medicare Payment Amount |
12238.76 |
Total Medical Medicare Standardized Payment Amount |
15593.75 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
112 |
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 |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
87 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.0627 |