Medicare Facts for Stacy S. Kelley, CNP


National Provider Identifier [NPI]: 1174802938
Last Name Of The Provider KELLEY
First Name Of The Provider STACY
Middle Initial Of The Provider S
Credentials Of The Provider CNP
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 6515 PULLMAN DR
Street Address 2 Of The Provider
City Of The Provider LEWIS CENTER
Zip Code Of The Provider 430357380
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 15
Number Of Services 117
Number Of Medicare Beneficiaries 73
Total Submitted Charge Amount 15947.4
Total Medicare Allowed Amount 7787.17
Total Medicare Payment Amount 5683.91
Total Medicare Standardized Payment Amount 6999.71
Drug Suppress Indicator *
Number Of HCPCS Associated With Drug Services
Number Of Drug Services
Number Of Medicare Beneficiaries With Drug Services
Total Drug Submitted ChargeAmount
Total Drug Medicare AllowedAmount
Total Drug Medicare PaymentAmount
Total Drug Medicare Standardized Payment Amount
Medical SuppressIndicator #
Number Of HCPCS Associated With MedicalServices
Number Of Medical Services
Number Of Medicare Beneficiaries With Medical Services
Total Medical Submitted Charge Amount
Total Medical Medicare Allowed Amount
Total Medical Medicare Payment Amount
Total Medical Medicare Standardized Payment Amount
Average Age Of Beneficiaries 68
Number Of Beneficiaries Age Less65 15
Number Of Beneficiaries Age 65 to 74 43
Number Of Beneficiaries Age 75 to 84
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 49
Number Of Male Beneficiaries 24
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 19
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 21
Percent Of With Diabetes 22
Percent Of With Hyperlipidemia 49
Percent Of With Hypertension 60
Percent Of With Ischemic Heart Disease 21
Percent Of With Osteoporosis 18
Percent Of With Rheumatoid Arthritis Osteoarthritis 42
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 1.0721

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