National Provider Identifier [NPI]: |
1104160217 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
KAYELA |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13500 SUTTON PARK DRIVE SOUTH |
Street Address 2 Of The Provider |
SUITE 403 |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322245291 |
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 |
3 |
Number Of Services |
2691 |
Number Of Medicare Beneficiaries |
637 |
Total Submitted Charge Amount |
370558 |
Total Medicare Allowed Amount |
160568.3 |
Total Medicare Payment Amount |
125729.16 |
Total Medicare Standardized Payment Amount |
146038.1 |
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 |
3 |
Number Of Medical Services |
2691 |
Number Of Medicare Beneficiaries With Medical Services |
637 |
Total Medical Submitted Charge Amount |
370558 |
Total Medical Medicare Allowed Amount |
160568.3 |
Total Medical Medicare Payment Amount |
125729.16 |
Total Medical Medicare Standardized Payment Amount |
146038.1 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
207 |
Number Of Beneficiaries Age Greater 84 |
254 |
Number Of Female Beneficiaries |
413 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
534 |
Number Of Black or African American Beneficiaries |
77 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
443 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
194 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
52 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.5183 |