National Provider Identifier [NPI]: |
1538170121 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
LUCILLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CFNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3000 SAINT MATTHEWS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORANGEBURG |
Zip Code Of The Provider |
291181442 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
167 |
Number Of Medicare Beneficiaries |
91 |
Total Submitted Charge Amount |
4100 |
Total Medicare Allowed Amount |
1334.89 |
Total Medicare Payment Amount |
1247.62 |
Total Medicare Standardized Payment Amount |
1292.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
13 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
360 |
Total Drug Medicare AllowedAmount |
231.68 |
Total Drug Medicare PaymentAmount |
226.75 |
Total Drug Medicare Standardized Payment Amount |
226.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
154 |
Number Of Medicare Beneficiaries With Medical Services |
89 |
Total Medical Submitted Charge Amount |
3740 |
Total Medical Medicare Allowed Amount |
1103.21 |
Total Medical Medicare Payment Amount |
1020.87 |
Total Medical Medicare Standardized Payment Amount |
1065.66 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
56 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
20 |
Number Of Black or African American Beneficiaries |
71 |
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 |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
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 |
|
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
15 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2194 |