National Provider Identifier [NPI]: |
1063754471 |
Last Name Of The Provider |
DIAGO |
First Name Of The Provider |
NANCY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
FNP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10652 S EASTERN AVE STE A |
Street Address 2 Of The Provider |
|
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890524953 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
206 |
Number Of Medicare Beneficiaries |
133 |
Total Submitted Charge Amount |
11258.02 |
Total Medicare Allowed Amount |
9797.15 |
Total Medicare Payment Amount |
6441.32 |
Total Medicare Standardized Payment Amount |
8238.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
1938.53 |
Total Drug Medicare AllowedAmount |
1613.19 |
Total Drug Medicare PaymentAmount |
1580.83 |
Total Drug Medicare Standardized Payment Amount |
1580.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
158 |
Number Of Medicare Beneficiaries With Medical Services |
132 |
Total Medical Submitted Charge Amount |
9319.49 |
Total Medical Medicare Allowed Amount |
8183.96 |
Total Medical Medicare Payment Amount |
4860.49 |
Total Medical Medicare Standardized Payment Amount |
6657.75 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
113 |
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 |
14 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.847 |