National Provider Identifier [NPI]: |
1548382252 |
Last Name Of The Provider |
KNOWLES |
First Name Of The Provider |
ANDREA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3905 DUE WEST RD NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
300641019 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
312 |
Number Of Medicare Beneficiaries |
145 |
Total Submitted Charge Amount |
11625.96 |
Total Medicare Allowed Amount |
10640.14 |
Total Medicare Payment Amount |
8268.02 |
Total Medicare Standardized Payment Amount |
9563.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
113 |
Number Of Medicare Beneficiaries With Drug Services |
95 |
Total Drug Submitted ChargeAmount |
3247.96 |
Total Drug Medicare AllowedAmount |
3247.96 |
Total Drug Medicare PaymentAmount |
3108.89 |
Total Drug Medicare Standardized Payment Amount |
3108.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
199 |
Number Of Medicare Beneficiaries With Medical Services |
145 |
Total Medical Submitted Charge Amount |
8378 |
Total Medical Medicare Allowed Amount |
7392.18 |
Total Medical Medicare Payment Amount |
5159.13 |
Total Medical Medicare Standardized Payment Amount |
6455.07 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
56 |
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 |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7916 |