National Provider Identifier [NPI]: |
1205081395 |
Last Name Of The Provider |
HARRELSON |
First Name Of The Provider |
ANDREA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2118 ROSALIND AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROANOKE |
Zip Code Of The Provider |
240141718 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
331 |
Number Of Medicare Beneficiaries |
218 |
Total Submitted Charge Amount |
32558 |
Total Medicare Allowed Amount |
21579.46 |
Total Medicare Payment Amount |
13838.78 |
Total Medicare Standardized Payment Amount |
17299.13 |
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 |
9 |
Number Of Medical Services |
331 |
Number Of Medicare Beneficiaries With Medical Services |
218 |
Total Medical Submitted Charge Amount |
32558 |
Total Medical Medicare Allowed Amount |
21579.46 |
Total Medical Medicare Payment Amount |
13838.78 |
Total Medical Medicare Standardized Payment Amount |
17299.13 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
204 |
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 |
73 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
145 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
60 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.4778 |