National Provider Identifier [NPI]: |
1053548297 |
Last Name Of The Provider |
DEES |
First Name Of The Provider |
LATASHA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1444 E SHELBY DR |
Street Address 2 Of The Provider |
SUITE 317 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381167260 |
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 |
18 |
Number Of Services |
93 |
Number Of Medicare Beneficiaries |
49 |
Total Submitted Charge Amount |
3976 |
Total Medicare Allowed Amount |
2966.23 |
Total Medicare Payment Amount |
2190.43 |
Total Medicare Standardized Payment Amount |
2599.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
34 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
535 |
Total Drug Medicare AllowedAmount |
352.41 |
Total Drug Medicare PaymentAmount |
342.29 |
Total Drug Medicare Standardized Payment Amount |
342.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
59 |
Number Of Medicare Beneficiaries With Medical Services |
49 |
Total Medical Submitted Charge Amount |
3441 |
Total Medical Medicare Allowed Amount |
2613.82 |
Total Medical Medicare Payment Amount |
1848.14 |
Total Medical Medicare Standardized Payment Amount |
2257.31 |
Average Age Of Beneficiaries |
69 |
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 |
35 |
Number Of Male Beneficiaries |
14 |
Number Of Non Hispanic White Beneficiaries |
38 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
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 |
22 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0557 |