National Provider Identifier [NPI]: |
1538432471 |
Last Name Of The Provider |
CARLSON |
First Name Of The Provider |
RACHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ANP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4015 LAKE OTIS PKWY |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
ANCHORAGE |
Zip Code Of The Provider |
995085211 |
State Code Of The Provider |
AK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
23861 |
Number Of Medicare Beneficiaries |
367 |
Total Submitted Charge Amount |
461899 |
Total Medicare Allowed Amount |
144886.81 |
Total Medicare Payment Amount |
106232.85 |
Total Medicare Standardized Payment Amount |
104132.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
22704 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
259504 |
Total Drug Medicare AllowedAmount |
60119.11 |
Total Drug Medicare PaymentAmount |
46617.74 |
Total Drug Medicare Standardized Payment Amount |
46617.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
1157 |
Number Of Medicare Beneficiaries With Medical Services |
365 |
Total Medical Submitted Charge Amount |
202395 |
Total Medical Medicare Allowed Amount |
84767.7 |
Total Medical Medicare Payment Amount |
59615.11 |
Total Medical Medicare Standardized Payment Amount |
57515.11 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
270 |
Number Of Black or African American Beneficiaries |
35 |
Number Of AsianPacific Islander Beneficiaries |
35 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.9001 |