National Provider Identifier [NPI]: |
1487973673 |
Last Name Of The Provider |
HARRISON |
First Name Of The Provider |
YULANDA |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
616 W. KEISER |
Street Address 2 Of The Provider |
|
City Of The Provider |
OSCEOLA |
Zip Code Of The Provider |
723703504 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
2484 |
Number Of Medicare Beneficiaries |
289 |
Total Submitted Charge Amount |
116059.6 |
Total Medicare Allowed Amount |
78451.24 |
Total Medicare Payment Amount |
49623.15 |
Total Medicare Standardized Payment Amount |
55484.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
609 |
Number Of Medicare Beneficiaries With Drug Services |
111 |
Total Drug Submitted ChargeAmount |
8355.6 |
Total Drug Medicare AllowedAmount |
2765.83 |
Total Drug Medicare PaymentAmount |
2287.5 |
Total Drug Medicare Standardized Payment Amount |
2287.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1875 |
Number Of Medicare Beneficiaries With Medical Services |
289 |
Total Medical Submitted Charge Amount |
107704 |
Total Medical Medicare Allowed Amount |
75685.41 |
Total Medical Medicare Payment Amount |
47335.65 |
Total Medical Medicare Standardized Payment Amount |
53197.34 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
95 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
216 |
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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.154 |