National Provider Identifier [NPI]: |
1144650169 |
Last Name Of The Provider |
KOBIA |
First Name Of The Provider |
SONYA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 DALLAS HWY SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
300641675 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
191 |
Number Of Medicare Beneficiaries |
96 |
Total Submitted Charge Amount |
10761 |
Total Medicare Allowed Amount |
7791.16 |
Total Medicare Payment Amount |
5399.04 |
Total Medicare Standardized Payment Amount |
6324.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
33 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
690 |
Total Drug Medicare AllowedAmount |
485.78 |
Total Drug Medicare PaymentAmount |
474.66 |
Total Drug Medicare Standardized Payment Amount |
474.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
158 |
Number Of Medicare Beneficiaries With Medical Services |
96 |
Total Medical Submitted Charge Amount |
10071 |
Total Medical Medicare Allowed Amount |
7305.38 |
Total Medical Medicare Payment Amount |
4924.38 |
Total Medical Medicare Standardized Payment Amount |
5850.06 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
36 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.7757 |