National Provider Identifier [NPI]: |
1457634834 |
Last Name Of The Provider |
CRABTREE |
First Name Of The Provider |
TINA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
APN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1210 S JACKSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULLAHOMA |
Zip Code Of The Provider |
373884386 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2201 |
Number Of Medicare Beneficiaries |
223 |
Total Submitted Charge Amount |
121799 |
Total Medicare Allowed Amount |
55979.64 |
Total Medicare Payment Amount |
38434.45 |
Total Medicare Standardized Payment Amount |
50011.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
859 |
Number Of Medicare Beneficiaries With Drug Services |
96 |
Total Drug Submitted ChargeAmount |
6562 |
Total Drug Medicare AllowedAmount |
1486.97 |
Total Drug Medicare PaymentAmount |
1306.17 |
Total Drug Medicare Standardized Payment Amount |
1306.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1342 |
Number Of Medicare Beneficiaries With Medical Services |
223 |
Total Medical Submitted Charge Amount |
115237 |
Total Medical Medicare Allowed Amount |
54492.67 |
Total Medical Medicare Payment Amount |
37128.28 |
Total Medical Medicare Standardized Payment Amount |
48705.69 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
146 |
Number Of Male Beneficiaries |
77 |
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 |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1541 |