National Provider Identifier [NPI]: |
1003057167 |
Last Name Of The Provider |
FREDERICKSEN |
First Name Of The Provider |
SARA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
ANP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 19TH ST |
Street Address 2 Of The Provider |
SUITE 501 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379161854 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1088 |
Number Of Medicare Beneficiaries |
207 |
Total Submitted Charge Amount |
115845 |
Total Medicare Allowed Amount |
65235.64 |
Total Medicare Payment Amount |
50748.22 |
Total Medicare Standardized Payment Amount |
63422.26 |
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 |
12 |
Number Of Medical Services |
1088 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
115845 |
Total Medical Medicare Allowed Amount |
65235.64 |
Total Medical Medicare Payment Amount |
50748.22 |
Total Medical Medicare Standardized Payment Amount |
63422.26 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
187 |
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 |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
73 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.9547 |