National Provider Identifier [NPI]: |
1912999517 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
SONYA |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
C.R.N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1509 RITCHIE HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARNOLD |
Zip Code Of The Provider |
210122742 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
764 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
49529 |
Total Medicare Allowed Amount |
26856.82 |
Total Medicare Payment Amount |
19827.99 |
Total Medicare Standardized Payment Amount |
21804.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
1240 |
Total Drug Medicare AllowedAmount |
926.65 |
Total Drug Medicare PaymentAmount |
899.86 |
Total Drug Medicare Standardized Payment Amount |
899.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
741 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
48289 |
Total Medical Medicare Allowed Amount |
25930.17 |
Total Medical Medicare Payment Amount |
18928.13 |
Total Medical Medicare Standardized Payment Amount |
20904.57 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
182 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
178 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
7 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
9 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
39 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7811 |