National Provider Identifier [NPI]: |
1649538166 |
Last Name Of The Provider |
LUCID |
First Name Of The Provider |
GENNELLE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 E COUNTY LINE RD |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
GREENWOOD |
Zip Code Of The Provider |
461431070 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
1926 |
Number Of Medicare Beneficiaries |
526 |
Total Submitted Charge Amount |
126687 |
Total Medicare Allowed Amount |
73341.76 |
Total Medicare Payment Amount |
54416.73 |
Total Medicare Standardized Payment Amount |
67067.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
176 |
Number Of Medicare Beneficiaries With Drug Services |
110 |
Total Drug Submitted ChargeAmount |
2335 |
Total Drug Medicare AllowedAmount |
934.73 |
Total Drug Medicare PaymentAmount |
744.31 |
Total Drug Medicare Standardized Payment Amount |
744.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
1750 |
Number Of Medicare Beneficiaries With Medical Services |
526 |
Total Medical Submitted Charge Amount |
124352 |
Total Medical Medicare Allowed Amount |
72407.03 |
Total Medical Medicare Payment Amount |
53672.42 |
Total Medical Medicare Standardized Payment Amount |
66322.76 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
179 |
Number Of Non Hispanic White Beneficiaries |
509 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
456 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
70 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2426 |