National Provider Identifier [NPI]: |
1376694083 |
Last Name Of The Provider |
CLAUDE |
First Name Of The Provider |
KIMBERLY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
850 HARRISON AVE |
Street Address 2 Of The Provider |
YACC, 3RD FLOOR |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021184001 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
759 |
Number Of Medicare Beneficiaries |
122 |
Total Submitted Charge Amount |
192930 |
Total Medicare Allowed Amount |
68317.2 |
Total Medicare Payment Amount |
50869.29 |
Total Medicare Standardized Payment Amount |
57082.12 |
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 |
8 |
Number Of Medical Services |
759 |
Number Of Medicare Beneficiaries With Medical Services |
122 |
Total Medical Submitted Charge Amount |
192930 |
Total Medical Medicare Allowed Amount |
68317.2 |
Total Medical Medicare Payment Amount |
50869.29 |
Total Medical Medicare Standardized Payment Amount |
57082.12 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
80 |
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
64 |
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.4786 |