National Provider Identifier [NPI]: |
1225464787 |
Last Name Of The Provider |
BEDELL |
First Name Of The Provider |
CAMMIE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4111 UNIVERSITY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757016623 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
408 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
63204 |
Total Medicare Allowed Amount |
31852.53 |
Total Medicare Payment Amount |
24906.16 |
Total Medicare Standardized Payment Amount |
30262.37 |
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 |
8 |
Number Of Medical Services |
408 |
Number Of Medicare Beneficiaries With Medical Services |
246 |
Total Medical Submitted Charge Amount |
63204 |
Total Medical Medicare Allowed Amount |
31852.53 |
Total Medical Medicare Payment Amount |
24906.16 |
Total Medical Medicare Standardized Payment Amount |
30262.37 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
195 |
Number Of Black or African American Beneficiaries |
37 |
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 |
168 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
68 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
48 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.864 |