National Provider Identifier [NPI]: |
1558516286 |
Last Name Of The Provider |
HAWKINS |
First Name Of The Provider |
PATRICIA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12700 SOUTHFORK RD |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631283201 |
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 |
3 |
Number Of Services |
1400 |
Number Of Medicare Beneficiaries |
446 |
Total Submitted Charge Amount |
140835 |
Total Medicare Allowed Amount |
81837.92 |
Total Medicare Payment Amount |
57952.37 |
Total Medicare Standardized Payment Amount |
70514.51 |
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 |
3 |
Number Of Medical Services |
1400 |
Number Of Medicare Beneficiaries With Medical Services |
446 |
Total Medical Submitted Charge Amount |
140835 |
Total Medical Medicare Allowed Amount |
81837.92 |
Total Medical Medicare Payment Amount |
57952.37 |
Total Medical Medicare Standardized Payment Amount |
70514.51 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
185 |
Number Of Female Beneficiaries |
310 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
353 |
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 |
55 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
391 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3667 |