National Provider Identifier [NPI]: |
1013163013 |
Last Name Of The Provider |
ENGLISH-PICKETT |
First Name Of The Provider |
MARLA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
GNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16060 BROADLEAF |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEXARKANA |
Zip Code Of The Provider |
755039607 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
786 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
97035.77 |
Total Medicare Allowed Amount |
58344.85 |
Total Medicare Payment Amount |
45138.32 |
Total Medicare Standardized Payment Amount |
55632.29 |
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 |
11 |
Number Of Medical Services |
786 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
97035.77 |
Total Medical Medicare Allowed Amount |
58344.85 |
Total Medical Medicare Payment Amount |
45138.32 |
Total Medical Medicare Standardized Payment Amount |
55632.29 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
120 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
168 |
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 |
44 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
150 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
62 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
28 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.2243 |