National Provider Identifier [NPI]: |
1134382484 |
Last Name Of The Provider |
MCEVOY |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
RN, MA, NP-C, |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
847 N BROADWAY |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
MASSAPEQUA |
Zip Code Of The Provider |
117582373 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
914 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
86729 |
Total Medicare Allowed Amount |
47453.43 |
Total Medicare Payment Amount |
33709.02 |
Total Medicare Standardized Payment Amount |
34458.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
58 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
1765 |
Total Drug Medicare AllowedAmount |
716.39 |
Total Drug Medicare PaymentAmount |
677.29 |
Total Drug Medicare Standardized Payment Amount |
677.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
856 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
84964 |
Total Medical Medicare Allowed Amount |
46737.04 |
Total Medical Medicare Payment Amount |
33031.73 |
Total Medical Medicare Standardized Payment Amount |
33781.61 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
240 |
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 |
238 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1114 |