National Provider Identifier [NPI]: |
1811029499 |
Last Name Of The Provider |
SMILEY |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 DUDLEY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029052401 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
380 |
Number Of Medicare Beneficiaries |
224 |
Total Submitted Charge Amount |
53492 |
Total Medicare Allowed Amount |
30141.43 |
Total Medicare Payment Amount |
23757.71 |
Total Medicare Standardized Payment Amount |
26638.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
905 |
Total Drug Medicare AllowedAmount |
674.24 |
Total Drug Medicare PaymentAmount |
653.38 |
Total Drug Medicare Standardized Payment Amount |
653.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
352 |
Number Of Medicare Beneficiaries With Medical Services |
224 |
Total Medical Submitted Charge Amount |
52587 |
Total Medical Medicare Allowed Amount |
29467.19 |
Total Medical Medicare Payment Amount |
23104.33 |
Total Medical Medicare Standardized Payment Amount |
25984.65 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
92 |
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 |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
15 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0568 |