National Provider Identifier [NPI]: |
1265720098 |
Last Name Of The Provider |
NICHOLSON |
First Name Of The Provider |
CHERYL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
FNP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
620 STANTON CHRISTIANA RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197132133 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
393 |
Number Of Medicare Beneficiaries |
247 |
Total Submitted Charge Amount |
67749 |
Total Medicare Allowed Amount |
24647.3 |
Total Medicare Payment Amount |
16934.13 |
Total Medicare Standardized Payment Amount |
20035.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
820 |
Total Drug Medicare AllowedAmount |
491.16 |
Total Drug Medicare PaymentAmount |
480.97 |
Total Drug Medicare Standardized Payment Amount |
480.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
377 |
Number Of Medicare Beneficiaries With Medical Services |
247 |
Total Medical Submitted Charge Amount |
66929 |
Total Medical Medicare Allowed Amount |
24156.14 |
Total Medical Medicare Payment Amount |
16453.16 |
Total Medical Medicare Standardized Payment Amount |
19554.96 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
172 |
Number Of Black or African American Beneficiaries |
46 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
108 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
61 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
45 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4328 |