National Provider Identifier [NPI]: |
1538437983 |
Last Name Of The Provider |
TUCKER |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5615 W GIRARD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191314128 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
80 |
Number Of Medicare Beneficiaries |
46 |
Total Submitted Charge Amount |
2629.67 |
Total Medicare Allowed Amount |
2140.32 |
Total Medicare Payment Amount |
1866.64 |
Total Medicare Standardized Payment Amount |
2271.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
707.8 |
Total Drug Medicare AllowedAmount |
582.59 |
Total Drug Medicare PaymentAmount |
570.9 |
Total Drug Medicare Standardized Payment Amount |
570.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
5 |
Number Of Medical Services |
60 |
Number Of Medicare Beneficiaries With Medical Services |
46 |
Total Medical Submitted Charge Amount |
1921.87 |
Total Medical Medicare Allowed Amount |
1557.73 |
Total Medical Medicare Payment Amount |
1295.74 |
Total Medical Medicare Standardized Payment Amount |
1701.04 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
25 |
Number Of Male Beneficiaries |
21 |
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 |
|
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 |
24 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6773 |