National Provider Identifier [NPI]: |
1124070289 |
Last Name Of The Provider |
PAYNE |
First Name Of The Provider |
LYNELLE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
APN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1350 CHESTER BLVD STE B |
Street Address 2 Of The Provider |
REID URGENT CARE |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
473741907 |
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 |
26 |
Number Of Services |
174 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
16933 |
Total Medicare Allowed Amount |
6495.66 |
Total Medicare Payment Amount |
4896.94 |
Total Medicare Standardized Payment Amount |
6038.82 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
35 |
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 |
75 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
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 |
23 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.106 |