National Provider Identifier [NPI]: |
1831333871 |
Last Name Of The Provider |
VINCENT |
First Name Of The Provider |
LESLEY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4711 POPLAR SPRINGS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MERIDIAN |
Zip Code Of The Provider |
393052622 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
4887 |
Number Of Medicare Beneficiaries |
524 |
Total Submitted Charge Amount |
474032.83 |
Total Medicare Allowed Amount |
195666.31 |
Total Medicare Payment Amount |
148298.67 |
Total Medicare Standardized Payment Amount |
180122.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
2490 |
Number Of Medicare Beneficiaries With Drug Services |
174 |
Total Drug Submitted ChargeAmount |
40930.83 |
Total Drug Medicare AllowedAmount |
27701.44 |
Total Drug Medicare PaymentAmount |
20907.9 |
Total Drug Medicare Standardized Payment Amount |
20907.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
2397 |
Number Of Medicare Beneficiaries With Medical Services |
524 |
Total Medical Submitted Charge Amount |
433102 |
Total Medical Medicare Allowed Amount |
167964.87 |
Total Medical Medicare Payment Amount |
127390.77 |
Total Medical Medicare Standardized Payment Amount |
159214.14 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
176 |
Number Of Beneficiaries Age 65 to 74 |
181 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
363 |
Number Of Male Beneficiaries |
161 |
Number Of Non Hispanic White Beneficiaries |
386 |
Number Of Black or African American Beneficiaries |
124 |
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 |
334 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
190 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3041 |