National Provider Identifier [NPI]: |
1982658399 |
Last Name Of The Provider |
BOLES |
First Name Of The Provider |
DEBORAH |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
520 HIGHLAND TERRACE |
Street Address 2 Of The Provider |
SUITE E |
City Of The Provider |
MURFREESBORO |
Zip Code Of The Provider |
37130 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
888 |
Number Of Medicare Beneficiaries |
166 |
Total Submitted Charge Amount |
60037 |
Total Medicare Allowed Amount |
29663.85 |
Total Medicare Payment Amount |
21182.13 |
Total Medicare Standardized Payment Amount |
26222.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
218 |
Number Of Medicare Beneficiaries With Drug Services |
82 |
Total Drug Submitted ChargeAmount |
3810 |
Total Drug Medicare AllowedAmount |
1336.79 |
Total Drug Medicare PaymentAmount |
1208.25 |
Total Drug Medicare Standardized Payment Amount |
1208.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
670 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
56227 |
Total Medical Medicare Allowed Amount |
28327.06 |
Total Medical Medicare Payment Amount |
19973.88 |
Total Medical Medicare Standardized Payment Amount |
25014.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
64 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.957 |