National Provider Identifier [NPI]: |
1811286305 |
Last Name Of The Provider |
TINDALL |
First Name Of The Provider |
SHERRY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ANP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
340 W LINCOLN ST |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
BELLEVILLE |
Zip Code Of The Provider |
622201900 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
455 |
Number Of Medicare Beneficiaries |
280 |
Total Submitted Charge Amount |
105997 |
Total Medicare Allowed Amount |
36709.84 |
Total Medicare Payment Amount |
28522.12 |
Total Medicare Standardized Payment Amount |
33031.39 |
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 |
14 |
Number Of Medical Services |
455 |
Number Of Medicare Beneficiaries With Medical Services |
280 |
Total Medical Submitted Charge Amount |
105997 |
Total Medical Medicare Allowed Amount |
36709.84 |
Total Medical Medicare Payment Amount |
28522.12 |
Total Medical Medicare Standardized Payment Amount |
33031.39 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
171 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
234 |
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 |
179 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
70 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
57 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.4348 |