National Provider Identifier [NPI]: |
1992756597 |
Last Name Of The Provider |
GUY |
First Name Of The Provider |
ALLISON |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 TAYLOR RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTGOMERY |
Zip Code Of The Provider |
361173512 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
175 |
Number Of Medicare Beneficiaries |
20 |
Total Submitted Charge Amount |
4086.89 |
Total Medicare Allowed Amount |
2982.99 |
Total Medicare Payment Amount |
1720.19 |
Total Medicare Standardized Payment Amount |
2288.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
94 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
230.2 |
Total Drug Medicare AllowedAmount |
126.08 |
Total Drug Medicare PaymentAmount |
96.36 |
Total Drug Medicare Standardized Payment Amount |
96.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
81 |
Number Of Medicare Beneficiaries With Medical Services |
20 |
Total Medical Submitted Charge Amount |
3856.69 |
Total Medical Medicare Allowed Amount |
2856.91 |
Total Medical Medicare Payment Amount |
1623.83 |
Total Medical Medicare Standardized Payment Amount |
2192.63 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
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Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
|
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.0211 |