National Provider Identifier [NPI]: |
1063644094 |
Last Name Of The Provider |
NIEVES |
First Name Of The Provider |
KRISTA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 N MILITARY TRL STE 150 |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOCA RATON |
Zip Code Of The Provider |
334316308 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1490 |
Number Of Medicare Beneficiaries |
199 |
Total Submitted Charge Amount |
32494.82 |
Total Medicare Allowed Amount |
27787.74 |
Total Medicare Payment Amount |
21897.53 |
Total Medicare Standardized Payment Amount |
23930.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
1268 |
Number Of Medicare Beneficiaries With Drug Services |
139 |
Total Drug Submitted ChargeAmount |
21484.52 |
Total Drug Medicare AllowedAmount |
20049.99 |
Total Drug Medicare PaymentAmount |
16428.74 |
Total Drug Medicare Standardized Payment Amount |
16428.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
222 |
Number Of Medicare Beneficiaries With Medical Services |
199 |
Total Medical Submitted Charge Amount |
11010.3 |
Total Medical Medicare Allowed Amount |
7737.75 |
Total Medical Medicare Payment Amount |
5468.79 |
Total Medical Medicare Standardized Payment Amount |
7501.7 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
183 |
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 |
185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.06 |