National Provider Identifier [NPI]: |
1295974954 |
Last Name Of The Provider |
DAVIS |
First Name Of The Provider |
ALISON |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 MCGREGOR ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANCHESTER |
Zip Code Of The Provider |
031023730 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
803 |
Number Of Medicare Beneficiaries |
381 |
Total Submitted Charge Amount |
129830 |
Total Medicare Allowed Amount |
46000.56 |
Total Medicare Payment Amount |
35317.88 |
Total Medicare Standardized Payment Amount |
41364.16 |
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 |
23 |
Number Of Medical Services |
803 |
Number Of Medicare Beneficiaries With Medical Services |
381 |
Total Medical Submitted Charge Amount |
129830 |
Total Medical Medicare Allowed Amount |
46000.56 |
Total Medical Medicare Payment Amount |
35317.88 |
Total Medical Medicare Standardized Payment Amount |
41364.16 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
368 |
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 |
318 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
46 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.8653 |