National Provider Identifier [NPI]: |
1932467032 |
Last Name Of The Provider |
GRACZYK |
First Name Of The Provider |
KRISTIN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15602 N DALE MABRY HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336181606 |
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 |
21 |
Number Of Services |
178 |
Number Of Medicare Beneficiaries |
71 |
Total Submitted Charge Amount |
8140.42 |
Total Medicare Allowed Amount |
6688.28 |
Total Medicare Payment Amount |
5120.21 |
Total Medicare Standardized Payment Amount |
5941.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
88 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
2885.72 |
Total Drug Medicare AllowedAmount |
2601.49 |
Total Drug Medicare PaymentAmount |
2211.05 |
Total Drug Medicare Standardized Payment Amount |
2211.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
90 |
Number Of Medicare Beneficiaries With Medical Services |
71 |
Total Medical Submitted Charge Amount |
5254.7 |
Total Medical Medicare Allowed Amount |
4086.79 |
Total Medical Medicare Payment Amount |
2909.16 |
Total Medical Medicare Standardized Payment Amount |
3730.86 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
16 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
20 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0664 |