National Provider Identifier [NPI]: |
1073526315 |
Last Name Of The Provider |
WILKINSON |
First Name Of The Provider |
SARA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5220 PARK AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381193500 |
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 |
22 |
Number Of Services |
129 |
Number Of Medicare Beneficiaries |
84 |
Total Submitted Charge Amount |
7388.82 |
Total Medicare Allowed Amount |
5776.15 |
Total Medicare Payment Amount |
3691.56 |
Total Medicare Standardized Payment Amount |
4966.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
549.82 |
Total Drug Medicare AllowedAmount |
455.02 |
Total Drug Medicare PaymentAmount |
445.89 |
Total Drug Medicare Standardized Payment Amount |
445.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
110 |
Number Of Medicare Beneficiaries With Medical Services |
84 |
Total Medical Submitted Charge Amount |
6839 |
Total Medical Medicare Allowed Amount |
5321.13 |
Total Medical Medicare Payment Amount |
3245.67 |
Total Medical Medicare Standardized Payment Amount |
4520.44 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
58 |
Number Of Male Beneficiaries |
26 |
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 |
|
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 |
13 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
19 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8131 |