National Provider Identifier [NPI]: |
1497185284 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
STACEY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 MATTHEW ST |
Street Address 2 Of The Provider |
SUITE 303 |
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
457501644 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
584 |
Number Of Medicare Beneficiaries |
364 |
Total Submitted Charge Amount |
80378 |
Total Medicare Allowed Amount |
26003.84 |
Total Medicare Payment Amount |
20026.87 |
Total Medicare Standardized Payment Amount |
24039.67 |
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 |
16 |
Number Of Medical Services |
584 |
Number Of Medicare Beneficiaries With Medical Services |
364 |
Total Medical Submitted Charge Amount |
80378 |
Total Medical Medicare Allowed Amount |
26003.84 |
Total Medical Medicare Payment Amount |
20026.87 |
Total Medical Medicare Standardized Payment Amount |
24039.67 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
166 |
Number Of Male Beneficiaries |
198 |
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 |
261 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3213 |