National Provider Identifier [NPI]: |
1255648051 |
Last Name Of The Provider |
SARTAIN |
First Name Of The Provider |
CHERYL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PMHNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1380 RIVER BEND DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752474914 |
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 |
7 |
Number Of Services |
305 |
Number Of Medicare Beneficiaries |
90 |
Total Submitted Charge Amount |
46468 |
Total Medicare Allowed Amount |
19364.49 |
Total Medicare Payment Amount |
15076.71 |
Total Medicare Standardized Payment Amount |
17761.77 |
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 |
7 |
Number Of Medical Services |
305 |
Number Of Medicare Beneficiaries With Medical Services |
90 |
Total Medical Submitted Charge Amount |
46468 |
Total Medical Medicare Allowed Amount |
19364.49 |
Total Medical Medicare Payment Amount |
15076.71 |
Total Medical Medicare Standardized Payment Amount |
17761.77 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
14 |
Number Of Beneficiaries Age 75 to 84 |
17 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
21 |
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 |
34 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
54 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
23 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2463 |