National Provider Identifier [NPI]: |
1659514073 |
Last Name Of The Provider |
LOWER |
First Name Of The Provider |
TONIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
262 W MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
AMELIA |
Zip Code Of The Provider |
451021309 |
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 |
50 |
Number Of Services |
318 |
Number Of Medicare Beneficiaries |
171 |
Total Submitted Charge Amount |
29582 |
Total Medicare Allowed Amount |
16962.71 |
Total Medicare Payment Amount |
11096.17 |
Total Medicare Standardized Payment Amount |
14037.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
37 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
223 |
Total Drug Medicare AllowedAmount |
105.56 |
Total Drug Medicare PaymentAmount |
80.8 |
Total Drug Medicare Standardized Payment Amount |
80.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
281 |
Number Of Medicare Beneficiaries With Medical Services |
171 |
Total Medical Submitted Charge Amount |
29359 |
Total Medical Medicare Allowed Amount |
16857.15 |
Total Medical Medicare Payment Amount |
11015.37 |
Total Medical Medicare Standardized Payment Amount |
13956.38 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
61 |
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9305 |