National Provider Identifier [NPI]: |
1407816762 |
Last Name Of The Provider |
GARRY |
First Name Of The Provider |
NATALIE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
GNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5323 HARRY HINES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
753908889 |
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 |
33 |
Number Of Services |
401 |
Number Of Medicare Beneficiaries |
172 |
Total Submitted Charge Amount |
94954 |
Total Medicare Allowed Amount |
31700.43 |
Total Medicare Payment Amount |
21741.46 |
Total Medicare Standardized Payment Amount |
25802.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
1064 |
Total Drug Medicare AllowedAmount |
464.35 |
Total Drug Medicare PaymentAmount |
455.01 |
Total Drug Medicare Standardized Payment Amount |
455.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
379 |
Number Of Medicare Beneficiaries With Medical Services |
172 |
Total Medical Submitted Charge Amount |
93890 |
Total Medical Medicare Allowed Amount |
31236.08 |
Total Medical Medicare Payment Amount |
21286.45 |
Total Medical Medicare Standardized Payment Amount |
25347.92 |
Average Age Of Beneficiaries |
85 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
141 |
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 |
153 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
65 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7651 |