National Provider Identifier [NPI]: |
1194799916 |
Last Name Of The Provider |
GROOM |
First Name Of The Provider |
LORI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6420 PROSPECT AVENUE |
Street Address 2 Of The Provider |
SUITE T-101 |
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
641321186 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
1517 |
Number Of Medicare Beneficiaries |
562 |
Total Submitted Charge Amount |
113818 |
Total Medicare Allowed Amount |
64176.86 |
Total Medicare Payment Amount |
50092.22 |
Total Medicare Standardized Payment Amount |
59870.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
62 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
2416 |
Total Drug Medicare AllowedAmount |
1494.12 |
Total Drug Medicare PaymentAmount |
1449.73 |
Total Drug Medicare Standardized Payment Amount |
1449.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
91 |
Number Of Medical Services |
1455 |
Number Of Medicare Beneficiaries With Medical Services |
562 |
Total Medical Submitted Charge Amount |
111402 |
Total Medical Medicare Allowed Amount |
62682.74 |
Total Medical Medicare Payment Amount |
48642.49 |
Total Medical Medicare Standardized Payment Amount |
58421.26 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
210 |
Number Of Beneficiaries Age 75 to 84 |
191 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
351 |
Number Of Male Beneficiaries |
211 |
Number Of Non Hispanic White Beneficiaries |
501 |
Number Of Black or African American Beneficiaries |
47 |
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 |
535 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0674 |