National Provider Identifier [NPI]: |
1336411313 |
Last Name Of The Provider |
DULIN |
First Name Of The Provider |
LUIS |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
APN |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
510 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GALLATIN |
Zip Code Of The Provider |
370662458 |
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 |
3 |
Number Of Services |
773 |
Number Of Medicare Beneficiaries |
185 |
Total Submitted Charge Amount |
55150 |
Total Medicare Allowed Amount |
44989.92 |
Total Medicare Payment Amount |
30430.67 |
Total Medicare Standardized Payment Amount |
39663.69 |
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 |
3 |
Number Of Medical Services |
773 |
Number Of Medicare Beneficiaries With Medical Services |
185 |
Total Medical Submitted Charge Amount |
55150 |
Total Medical Medicare Allowed Amount |
44989.92 |
Total Medical Medicare Payment Amount |
30430.67 |
Total Medical Medicare Standardized Payment Amount |
39663.69 |
Average Age Of Beneficiaries |
53 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
120 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
162 |
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 |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
73 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
28 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2878 |