National Provider Identifier [NPI]: |
1275547218 |
Last Name Of The Provider |
ESSARY |
First Name Of The Provider |
DEBORAH |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2115 S FREMONT AVE |
Street Address 2 Of The Provider |
SUITE 3000 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042239 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
35103 |
Number Of Medicare Beneficiaries |
222 |
Total Submitted Charge Amount |
338422.9 |
Total Medicare Allowed Amount |
166914.94 |
Total Medicare Payment Amount |
129045.39 |
Total Medicare Standardized Payment Amount |
137028.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
34392 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
266103.9 |
Total Drug Medicare AllowedAmount |
125767.79 |
Total Drug Medicare PaymentAmount |
97538.45 |
Total Drug Medicare Standardized Payment Amount |
97538.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
711 |
Number Of Medicare Beneficiaries With Medical Services |
222 |
Total Medical Submitted Charge Amount |
72319 |
Total Medical Medicare Allowed Amount |
41147.15 |
Total Medical Medicare Payment Amount |
31506.94 |
Total Medical Medicare Standardized Payment Amount |
39490.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
111 |
Number Of Male Beneficiaries |
111 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
50 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3424 |