National Provider Identifier [NPI]: |
1558606848 |
Last Name Of The Provider |
CLEVELAND |
First Name Of The Provider |
KIRA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1010 GLENBROOK WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
HENDERSONVILLE |
Zip Code Of The Provider |
370751230 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
140 |
Number Of Medicare Beneficiaries |
80 |
Total Submitted Charge Amount |
7921 |
Total Medicare Allowed Amount |
5533.71 |
Total Medicare Payment Amount |
4001.68 |
Total Medicare Standardized Payment Amount |
5006.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
565 |
Total Drug Medicare AllowedAmount |
443.61 |
Total Drug Medicare PaymentAmount |
433.35 |
Total Drug Medicare Standardized Payment Amount |
433.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
109 |
Number Of Medicare Beneficiaries With Medical Services |
80 |
Total Medical Submitted Charge Amount |
7356 |
Total Medical Medicare Allowed Amount |
5090.1 |
Total Medical Medicare Payment Amount |
3568.33 |
Total Medical Medicare Standardized Payment Amount |
4573.2 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
53 |
Number Of Male Beneficiaries |
27 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
|
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 |
19 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
14 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7989 |