National Provider Identifier [NPI]: |
1851584791 |
Last Name Of The Provider |
BUCKALEW |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ARNP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7472 DOCS GROVE CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORLANDO |
Zip Code Of The Provider |
328198010 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
73 |
Number Of Medicare Beneficiaries |
46 |
Total Submitted Charge Amount |
4011.84 |
Total Medicare Allowed Amount |
3440.96 |
Total Medicare Payment Amount |
2474.03 |
Total Medicare Standardized Payment Amount |
3029.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
742.84 |
Total Drug Medicare AllowedAmount |
638.39 |
Total Drug Medicare PaymentAmount |
625.56 |
Total Drug Medicare Standardized Payment Amount |
625.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
55 |
Number Of Medicare Beneficiaries With Medical Services |
46 |
Total Medical Submitted Charge Amount |
3269 |
Total Medical Medicare Allowed Amount |
2802.57 |
Total Medical Medicare Payment Amount |
1848.47 |
Total Medical Medicare Standardized Payment Amount |
2404.28 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
31 |
Number Of Male Beneficiaries |
15 |
Number Of Non Hispanic White Beneficiaries |
34 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.722 |