National Provider Identifier [NPI]: |
1780810887 |
Last Name Of The Provider |
STEWART |
First Name Of The Provider |
RACHEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1617 HEMPHILL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761044709 |
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 |
6 |
Number Of Services |
355 |
Number Of Medicare Beneficiaries |
184 |
Total Submitted Charge Amount |
66139.9 |
Total Medicare Allowed Amount |
28195.65 |
Total Medicare Payment Amount |
20383.8 |
Total Medicare Standardized Payment Amount |
24756.93 |
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 |
6 |
Number Of Medical Services |
355 |
Number Of Medicare Beneficiaries With Medical Services |
184 |
Total Medical Submitted Charge Amount |
66139.9 |
Total Medical Medicare Allowed Amount |
28195.65 |
Total Medical Medicare Payment Amount |
20383.8 |
Total Medical Medicare Standardized Payment Amount |
24756.93 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
11 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
80 |
Number Of Black or African American Beneficiaries |
67 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
18 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.373 |