National Provider Identifier [NPI]: |
1164616058 |
Last Name Of The Provider |
GIPSON |
First Name Of The Provider |
HELEN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 N STATE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164500 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
233 |
Number Of Medicare Beneficiaries |
109 |
Total Submitted Charge Amount |
51800 |
Total Medicare Allowed Amount |
21260.79 |
Total Medicare Payment Amount |
16175.91 |
Total Medicare Standardized Payment Amount |
20345.34 |
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 |
13 |
Number Of Medical Services |
233 |
Number Of Medicare Beneficiaries With Medical Services |
109 |
Total Medical Submitted Charge Amount |
51800 |
Total Medical Medicare Allowed Amount |
21260.79 |
Total Medical Medicare Payment Amount |
16175.91 |
Total Medical Medicare Standardized Payment Amount |
20345.34 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
71 |
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 |
51 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
75 |
Average HCC Risk Score Of Beneficiaries |
1.8253 |