National Provider Identifier [NPI]: |
1609009117 |
Last Name Of The Provider |
DANIEL |
First Name Of The Provider |
SABRINA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5670 PEACHTREE DUNWOODY RD NE STE 950 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303424790 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
607 |
Number Of Medicare Beneficiaries |
270 |
Total Submitted Charge Amount |
96116 |
Total Medicare Allowed Amount |
28734.31 |
Total Medicare Payment Amount |
21008.9 |
Total Medicare Standardized Payment Amount |
25611.68 |
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 |
7 |
Number Of Medical Services |
607 |
Number Of Medicare Beneficiaries With Medical Services |
270 |
Total Medical Submitted Charge Amount |
96116 |
Total Medical Medicare Allowed Amount |
28734.31 |
Total Medical Medicare Payment Amount |
21008.9 |
Total Medical Medicare Standardized Payment Amount |
25611.68 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
171 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
259 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
236 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5879 |