National Provider Identifier [NPI]: |
1518088640 |
Last Name Of The Provider |
GILBERT |
First Name Of The Provider |
LILLA |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1130 TOWER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LORAIN |
Zip Code Of The Provider |
440525235 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
986 |
Number Of Medicare Beneficiaries |
229 |
Total Submitted Charge Amount |
349994 |
Total Medicare Allowed Amount |
74394.8 |
Total Medicare Payment Amount |
54656.24 |
Total Medicare Standardized Payment Amount |
66805.38 |
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 |
4 |
Number Of Medical Services |
986 |
Number Of Medicare Beneficiaries With Medical Services |
229 |
Total Medical Submitted Charge Amount |
349994 |
Total Medical Medicare Allowed Amount |
74394.8 |
Total Medical Medicare Payment Amount |
54656.24 |
Total Medical Medicare Standardized Payment Amount |
66805.38 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
213 |
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 |
88 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
62 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
27 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.4545 |