National Provider Identifier [NPI]: |
1174829733 |
Last Name Of The Provider |
CABE |
First Name Of The Provider |
KIMBERLY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1203 JEFFERSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAUREL |
Zip Code Of The Provider |
394404354 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
345 |
Number Of Medicare Beneficiaries |
163 |
Total Submitted Charge Amount |
23053.36 |
Total Medicare Allowed Amount |
17660.05 |
Total Medicare Payment Amount |
11271.93 |
Total Medicare Standardized Payment Amount |
16974.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
63 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
198.9 |
Total Drug Medicare AllowedAmount |
197.27 |
Total Drug Medicare PaymentAmount |
161.72 |
Total Drug Medicare Standardized Payment Amount |
161.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
282 |
Number Of Medicare Beneficiaries With Medical Services |
163 |
Total Medical Submitted Charge Amount |
22854.46 |
Total Medical Medicare Allowed Amount |
17462.78 |
Total Medical Medicare Payment Amount |
11110.21 |
Total Medical Medicare Standardized Payment Amount |
16812.93 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
124 |
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 |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5059 |