National Provider Identifier [NPI]: |
1689952012 |
Last Name Of The Provider |
GROGAN |
First Name Of The Provider |
SHERRY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
RN, PMHNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6560 FANNIN ST |
Street Address 2 Of The Provider |
SUITE 1878 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770302761 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
826 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
293461 |
Total Medicare Allowed Amount |
70005.29 |
Total Medicare Payment Amount |
53597.73 |
Total Medicare Standardized Payment Amount |
63342.72 |
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 |
11 |
Number Of Medical Services |
826 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
293461 |
Total Medical Medicare Allowed Amount |
70005.29 |
Total Medical Medicare Payment Amount |
53597.73 |
Total Medical Medicare Standardized Payment Amount |
63342.72 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
134 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
11 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
111 |
Number Of Black or African American Beneficiaries |
52 |
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 |
135 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
74 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
5.0189 |