National Provider Identifier [NPI]: |
1518944560 |
Last Name Of The Provider |
CLEARMAN |
First Name Of The Provider |
SELENA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7100 U S HIGHWAY 98 |
Street Address 2 Of The Provider |
SUITE 140 |
City Of The Provider |
HATTIESBURG |
Zip Code Of The Provider |
394028516 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1148 |
Number Of Medicare Beneficiaries |
180 |
Total Submitted Charge Amount |
97572 |
Total Medicare Allowed Amount |
32613.12 |
Total Medicare Payment Amount |
23419.74 |
Total Medicare Standardized Payment Amount |
29650.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
332 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
13832 |
Total Drug Medicare AllowedAmount |
4508.08 |
Total Drug Medicare PaymentAmount |
3642.3 |
Total Drug Medicare Standardized Payment Amount |
3642.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
816 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
83740 |
Total Medical Medicare Allowed Amount |
28105.04 |
Total Medical Medicare Payment Amount |
19777.44 |
Total Medical Medicare Standardized Payment Amount |
26008.03 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
148 |
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 |
124 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9379 |