National Provider Identifier [NPI]: |
1144496233 |
Last Name Of The Provider |
HAILEY |
First Name Of The Provider |
PATRICIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
ANP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
27 COUNTY ROAD 950 |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROOKLAND |
Zip Code Of The Provider |
724178687 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
381 |
Number Of Medicare Beneficiaries |
336 |
Total Submitted Charge Amount |
441736 |
Total Medicare Allowed Amount |
39271.65 |
Total Medicare Payment Amount |
29330.29 |
Total Medicare Standardized Payment Amount |
36954.51 |
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 |
13 |
Number Of Medical Services |
381 |
Number Of Medicare Beneficiaries With Medical Services |
336 |
Total Medical Submitted Charge Amount |
441736 |
Total Medical Medicare Allowed Amount |
39271.65 |
Total Medical Medicare Payment Amount |
29330.29 |
Total Medical Medicare Standardized Payment Amount |
36954.51 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
216 |
Number Of Male Beneficiaries |
120 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.4505 |