National Provider Identifier [NPI]: |
1790031904 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
CRYSTAL |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13800 HULL STREET RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIDLOTHIAN |
Zip Code Of The Provider |
231122002 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
223 |
Number Of Medicare Beneficiaries |
116 |
Total Submitted Charge Amount |
6587.97 |
Total Medicare Allowed Amount |
6449.6 |
Total Medicare Payment Amount |
5803.52 |
Total Medicare Standardized Payment Amount |
6403.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
103 |
Number Of Medicare Beneficiaries With Drug Services |
102 |
Total Drug Submitted ChargeAmount |
3173.97 |
Total Drug Medicare AllowedAmount |
3173.97 |
Total Drug Medicare PaymentAmount |
3110.47 |
Total Drug Medicare Standardized Payment Amount |
3110.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
120 |
Number Of Medicare Beneficiaries With Medical Services |
116 |
Total Medical Submitted Charge Amount |
3414 |
Total Medical Medicare Allowed Amount |
3275.63 |
Total Medical Medicare Payment Amount |
2693.05 |
Total Medical Medicare Standardized Payment Amount |
3293.18 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
105 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
13 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8421 |