National Provider Identifier [NPI]: |
1619160132 |
Last Name Of The Provider |
BELL |
First Name Of The Provider |
KRISTEN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
FNP, BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1375 W 86TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462602101 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
219 |
Number Of Medicare Beneficiaries |
123 |
Total Submitted Charge Amount |
9883.3 |
Total Medicare Allowed Amount |
8529.57 |
Total Medicare Payment Amount |
6916.1 |
Total Medicare Standardized Payment Amount |
8106.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
71 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
2316.3 |
Total Drug Medicare AllowedAmount |
2197.74 |
Total Drug Medicare PaymentAmount |
2153.58 |
Total Drug Medicare Standardized Payment Amount |
2153.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
148 |
Number Of Medicare Beneficiaries With Medical Services |
123 |
Total Medical Submitted Charge Amount |
7567 |
Total Medical Medicare Allowed Amount |
6331.83 |
Total Medical Medicare Payment Amount |
4762.52 |
Total Medical Medicare Standardized Payment Amount |
5952.79 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
105 |
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 |
110 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
24 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7765 |