National Provider Identifier [NPI]: |
1275508749 |
Last Name Of The Provider |
STEWART |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
APRN-CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
212 N MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FAIRFAX |
Zip Code Of The Provider |
746373023 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
535 |
Number Of Medicare Beneficiaries |
425 |
Total Submitted Charge Amount |
398325 |
Total Medicare Allowed Amount |
43484.59 |
Total Medicare Payment Amount |
33648.36 |
Total Medicare Standardized Payment Amount |
41236.06 |
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 |
27 |
Number Of Medical Services |
535 |
Number Of Medicare Beneficiaries With Medical Services |
425 |
Total Medical Submitted Charge Amount |
398325 |
Total Medical Medicare Allowed Amount |
43484.59 |
Total Medical Medicare Payment Amount |
33648.36 |
Total Medical Medicare Standardized Payment Amount |
41236.06 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
254 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
345 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
56 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
184 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3645 |