National Provider Identifier [NPI]: |
1245480979 |
Last Name Of The Provider |
POGUE |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2158 INTELLIPLEX DR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SHELBYVILLE |
Zip Code Of The Provider |
461768548 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
2741 |
Number Of Medicare Beneficiaries |
299 |
Total Submitted Charge Amount |
232725 |
Total Medicare Allowed Amount |
134121.76 |
Total Medicare Payment Amount |
96095.63 |
Total Medicare Standardized Payment Amount |
121003.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
21 |
Number Of Drug Services |
832 |
Number Of Medicare Beneficiaries With Drug Services |
147 |
Total Drug Submitted ChargeAmount |
22898 |
Total Drug Medicare AllowedAmount |
9504.38 |
Total Drug Medicare PaymentAmount |
8183.95 |
Total Drug Medicare Standardized Payment Amount |
8183.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
1909 |
Number Of Medicare Beneficiaries With Medical Services |
299 |
Total Medical Submitted Charge Amount |
209827 |
Total Medical Medicare Allowed Amount |
124617.38 |
Total Medical Medicare Payment Amount |
87911.68 |
Total Medical Medicare Standardized Payment Amount |
112819.7 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
185 |
Number Of Male Beneficiaries |
114 |
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 |
188 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2853 |