National Provider Identifier [NPI]: |
1124321088 |
Last Name Of The Provider |
GILBERT |
First Name Of The Provider |
ANITA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
89 HILLSIDE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TORRINGTON |
Zip Code Of The Provider |
067905525 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
289 |
Number Of Medicare Beneficiaries |
156 |
Total Submitted Charge Amount |
10279.83 |
Total Medicare Allowed Amount |
9830.28 |
Total Medicare Payment Amount |
8285.37 |
Total Medicare Standardized Payment Amount |
9060.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
117 |
Number Of Medicare Beneficiaries With Drug Services |
112 |
Total Drug Submitted ChargeAmount |
3520.83 |
Total Drug Medicare AllowedAmount |
3520.83 |
Total Drug Medicare PaymentAmount |
3450.39 |
Total Drug Medicare Standardized Payment Amount |
3450.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
172 |
Number Of Medicare Beneficiaries With Medical Services |
156 |
Total Medical Submitted Charge Amount |
6759 |
Total Medical Medicare Allowed Amount |
6309.45 |
Total Medical Medicare Payment Amount |
4834.98 |
Total Medical Medicare Standardized Payment Amount |
5609.91 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
142 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8937 |