National Provider Identifier [NPI]: |
1528406345 |
Last Name Of The Provider |
COFFMAN |
First Name Of The Provider |
SABRINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
913 N DIXIE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ELIZABETHTOWN |
Zip Code Of The Provider |
42701 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
565 |
Number Of Medicare Beneficiaries |
115 |
Total Submitted Charge Amount |
54224 |
Total Medicare Allowed Amount |
27913.75 |
Total Medicare Payment Amount |
21807.27 |
Total Medicare Standardized Payment Amount |
26938.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
71 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
3365 |
Total Drug Medicare AllowedAmount |
863.34 |
Total Drug Medicare PaymentAmount |
832.25 |
Total Drug Medicare Standardized Payment Amount |
832.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
494 |
Number Of Medicare Beneficiaries With Medical Services |
115 |
Total Medical Submitted Charge Amount |
50859 |
Total Medical Medicare Allowed Amount |
27050.41 |
Total Medical Medicare Payment Amount |
20975.02 |
Total Medical Medicare Standardized Payment Amount |
26105.76 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
32 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
95 |
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 |
40 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0085 |