National Provider Identifier [NPI]: |
1912906421 |
Last Name Of The Provider |
HEATHCOTT |
First Name Of The Provider |
SHARI |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1445 PARR AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DYERSBURG |
Zip Code Of The Provider |
380243153 |
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 |
23 |
Number Of Services |
1595 |
Number Of Medicare Beneficiaries |
248 |
Total Submitted Charge Amount |
104177 |
Total Medicare Allowed Amount |
57279.89 |
Total Medicare Payment Amount |
34358.42 |
Total Medicare Standardized Payment Amount |
47941.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
413 |
Number Of Medicare Beneficiaries With Drug Services |
140 |
Total Drug Submitted ChargeAmount |
10940 |
Total Drug Medicare AllowedAmount |
816.87 |
Total Drug Medicare PaymentAmount |
665.12 |
Total Drug Medicare Standardized Payment Amount |
665.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
1182 |
Number Of Medicare Beneficiaries With Medical Services |
248 |
Total Medical Submitted Charge Amount |
93237 |
Total Medical Medicare Allowed Amount |
56463.02 |
Total Medical Medicare Payment Amount |
33693.3 |
Total Medical Medicare Standardized Payment Amount |
47276.09 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
93 |
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 |
233 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8293 |