National Provider Identifier [NPI]: |
1740616390 |
Last Name Of The Provider |
REYNOLDS |
First Name Of The Provider |
LATRISTA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1929 BRUCE B DOWNS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WESLEY CHAPEL |
Zip Code Of The Provider |
335449202 |
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 |
18 |
Number Of Services |
135 |
Number Of Medicare Beneficiaries |
67 |
Total Submitted Charge Amount |
5321.5 |
Total Medicare Allowed Amount |
4899.83 |
Total Medicare Payment Amount |
4078.43 |
Total Medicare Standardized Payment Amount |
4581.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
50 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
1710.5 |
Total Drug Medicare AllowedAmount |
1710.5 |
Total Drug Medicare PaymentAmount |
1676.28 |
Total Drug Medicare Standardized Payment Amount |
1676.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
85 |
Number Of Medicare Beneficiaries With Medical Services |
67 |
Total Medical Submitted Charge Amount |
3611 |
Total Medical Medicare Allowed Amount |
3189.33 |
Total Medical Medicare Payment Amount |
2402.15 |
Total Medical Medicare Standardized Payment Amount |
2905.34 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
28 |
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 |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
18 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8105 |