National Provider Identifier [NPI]: |
1124090246 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
LEAANNE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
S-3414 MEDICAL CTR N |
Street Address 2 Of The Provider |
VANDERBILT UNIVERSITY MEDICAL CENTER |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372320001 |
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 |
10 |
Number Of Services |
219 |
Number Of Medicare Beneficiaries |
81 |
Total Submitted Charge Amount |
38555 |
Total Medicare Allowed Amount |
13889.44 |
Total Medicare Payment Amount |
10737.48 |
Total Medicare Standardized Payment Amount |
13279.79 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
219 |
Number Of Medicare Beneficiaries With Medical Services |
81 |
Total Medical Submitted Charge Amount |
38555 |
Total Medical Medicare Allowed Amount |
13889.44 |
Total Medical Medicare Payment Amount |
10737.48 |
Total Medical Medicare Standardized Payment Amount |
13279.79 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
18 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
63 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
33 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
63 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
25 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.9114 |