National Provider Identifier [NPI]: |
1902901978 |
Last Name Of The Provider |
ZIMMERMAN |
First Name Of The Provider |
CAROL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3300 MAIN ST |
Street Address 2 Of The Provider |
3RD FLOOR SUITE C&D |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
011991002 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
421 |
Number Of Medicare Beneficiaries |
255 |
Total Submitted Charge Amount |
90567 |
Total Medicare Allowed Amount |
38253.34 |
Total Medicare Payment Amount |
27540.64 |
Total Medicare Standardized Payment Amount |
31939.31 |
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 |
3 |
Number Of Medical Services |
421 |
Number Of Medicare Beneficiaries With Medical Services |
255 |
Total Medical Submitted Charge Amount |
90567 |
Total Medical Medicare Allowed Amount |
38253.34 |
Total Medical Medicare Payment Amount |
27540.64 |
Total Medical Medicare Standardized Payment Amount |
31939.31 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
140 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
59 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5726 |