National Provider Identifier [NPI]: |
1154351658 |
Last Name Of The Provider |
KERR |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 WALTER SCHOLER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
479096303 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
560 |
Number Of Medicare Beneficiaries |
351 |
Total Submitted Charge Amount |
99589 |
Total Medicare Allowed Amount |
38688.42 |
Total Medicare Payment Amount |
29796.85 |
Total Medicare Standardized Payment Amount |
36911 |
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 |
12 |
Number Of Medical Services |
560 |
Number Of Medicare Beneficiaries With Medical Services |
351 |
Total Medical Submitted Charge Amount |
99589 |
Total Medical Medicare Allowed Amount |
38688.42 |
Total Medical Medicare Payment Amount |
29796.85 |
Total Medical Medicare Standardized Payment Amount |
36911 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
232 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
336 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
255 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
44 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
42 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9917 |