National Provider Identifier [NPI]: |
1669799169 |
Last Name Of The Provider |
COLLINS |
First Name Of The Provider |
KRYSTAL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
APRN, BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 N WEISGARBER RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379092706 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
7866 |
Number Of Medicare Beneficiaries |
240 |
Total Submitted Charge Amount |
227738.57 |
Total Medicare Allowed Amount |
145185.68 |
Total Medicare Payment Amount |
106149.25 |
Total Medicare Standardized Payment Amount |
109520.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
4230 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
153431.57 |
Total Drug Medicare AllowedAmount |
111400.82 |
Total Drug Medicare PaymentAmount |
81789.18 |
Total Drug Medicare Standardized Payment Amount |
81789.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
3636 |
Number Of Medicare Beneficiaries With Medical Services |
240 |
Total Medical Submitted Charge Amount |
74307 |
Total Medical Medicare Allowed Amount |
33784.86 |
Total Medical Medicare Payment Amount |
24360.07 |
Total Medical Medicare Standardized Payment Amount |
27731.2 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
145 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
157 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
226 |
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 |
203 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
34 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8412 |