National Provider Identifier [NPI]: |
1477981140 |
Last Name Of The Provider |
MOKRIS |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3133 LEE HWY |
Street Address 2 Of The Provider |
MINUTECLINIC |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
222014207 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
184 |
Number Of Medicare Beneficiaries |
102 |
Total Submitted Charge Amount |
7303.32 |
Total Medicare Allowed Amount |
6868.72 |
Total Medicare Payment Amount |
5487.04 |
Total Medicare Standardized Payment Amount |
6178.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
68 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
2108.32 |
Total Drug Medicare AllowedAmount |
1989.76 |
Total Drug Medicare PaymentAmount |
1875.51 |
Total Drug Medicare Standardized Payment Amount |
1875.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
116 |
Number Of Medicare Beneficiaries With Medical Services |
102 |
Total Medical Submitted Charge Amount |
5195 |
Total Medical Medicare Allowed Amount |
4878.96 |
Total Medical Medicare Payment Amount |
3611.53 |
Total Medical Medicare Standardized Payment Amount |
4303.42 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
40 |
Number Of Non Hispanic White Beneficiaries |
85 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
41 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.719 |