National Provider Identifier [NPI]: |
1679857833 |
Last Name Of The Provider |
LISTER |
First Name Of The Provider |
LAUNA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13400 E SHEA BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
852595452 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
893 |
Number Of Medicare Beneficiaries |
370 |
Total Submitted Charge Amount |
25563.7 |
Total Medicare Allowed Amount |
24536.25 |
Total Medicare Payment Amount |
20971.21 |
Total Medicare Standardized Payment Amount |
25035.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
87 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
865.76 |
Total Drug Medicare AllowedAmount |
865.75 |
Total Drug Medicare PaymentAmount |
821.33 |
Total Drug Medicare Standardized Payment Amount |
821.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
806 |
Number Of Medicare Beneficiaries With Medical Services |
366 |
Total Medical Submitted Charge Amount |
24697.94 |
Total Medical Medicare Allowed Amount |
23670.5 |
Total Medical Medicare Payment Amount |
20149.88 |
Total Medical Medicare Standardized Payment Amount |
24213.72 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
180 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
349 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
40 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4569 |