National Provider Identifier [NPI]: |
1437464815 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
KRISTINA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
ONE KING'S DAUGHTERS' DR. |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
472503357 |
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 |
12 |
Number Of Services |
340 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
158176 |
Total Medicare Allowed Amount |
20643.37 |
Total Medicare Payment Amount |
14049.11 |
Total Medicare Standardized Payment Amount |
17722.33 |
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 |
12 |
Number Of Medical Services |
340 |
Number Of Medicare Beneficiaries With Medical Services |
291 |
Total Medical Submitted Charge Amount |
158176 |
Total Medical Medicare Allowed Amount |
20643.37 |
Total Medical Medicare Payment Amount |
14049.11 |
Total Medical Medicare Standardized Payment Amount |
17722.33 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
153 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
261 |
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 |
152 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.5632 |