National Provider Identifier [NPI]: |
1841626314 |
Last Name Of The Provider |
FRACCHIA |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
365 MONTAUK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW LONDON |
Zip Code Of The Provider |
063204700 |
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 |
1144 |
Number Of Medicare Beneficiaries |
519 |
Total Submitted Charge Amount |
225323 |
Total Medicare Allowed Amount |
102868.58 |
Total Medicare Payment Amount |
80646.66 |
Total Medicare Standardized Payment Amount |
89567.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
1144 |
Number Of Medicare Beneficiaries With Medical Services |
519 |
Total Medical Submitted Charge Amount |
225323 |
Total Medical Medicare Allowed Amount |
102868.58 |
Total Medical Medicare Payment Amount |
80646.66 |
Total Medical Medicare Standardized Payment Amount |
89567.21 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
169 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
446 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
206 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2002 |