National Provider Identifier [NPI]: |
1962741223 |
Last Name Of The Provider |
MCGILL |
First Name Of The Provider |
SAMANTHA |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
NP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1278 OCEAN SPRINGS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
OCEAN SPRINGS |
Zip Code Of The Provider |
395643409 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
861 |
Number Of Medicare Beneficiaries |
250 |
Total Submitted Charge Amount |
98142 |
Total Medicare Allowed Amount |
57989.32 |
Total Medicare Payment Amount |
40227.91 |
Total Medicare Standardized Payment Amount |
54239.66 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
189 |
Number Of Black or African American Beneficiaries |
49 |
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 |
182 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7716 |