National Provider Identifier [NPI]: |
1568701100 |
Last Name Of The Provider |
WOODWARD |
First Name Of The Provider |
TRACIE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1375 FLOWERING DOGWOOD LN STE A |
Street Address 2 Of The Provider |
|
City Of The Provider |
DYERSBURG |
Zip Code Of The Provider |
380242948 |
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 |
72 |
Number Of Services |
3215 |
Number Of Medicare Beneficiaries |
406 |
Total Submitted Charge Amount |
152061 |
Total Medicare Allowed Amount |
62822.48 |
Total Medicare Payment Amount |
43809.7 |
Total Medicare Standardized Payment Amount |
57699.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
1770 |
Number Of Medicare Beneficiaries With Drug Services |
229 |
Total Drug Submitted ChargeAmount |
32042 |
Total Drug Medicare AllowedAmount |
991.19 |
Total Drug Medicare PaymentAmount |
754.3 |
Total Drug Medicare Standardized Payment Amount |
754.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
1445 |
Number Of Medicare Beneficiaries With Medical Services |
406 |
Total Medical Submitted Charge Amount |
120019 |
Total Medical Medicare Allowed Amount |
61831.29 |
Total Medical Medicare Payment Amount |
43055.4 |
Total Medical Medicare Standardized Payment Amount |
56945.14 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
93 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
266 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
390 |
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 |
301 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0571 |