National Provider Identifier [NPI]: |
1043285091 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
SHAWN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
ACNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 21ST AVE S |
Street Address 2 Of The Provider |
MCE 5TH FLOOR SOUTH TOWER, SUITE 5209 |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372328802 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
281 |
Number Of Medicare Beneficiaries |
159 |
Total Submitted Charge Amount |
37427.77 |
Total Medicare Allowed Amount |
16041.74 |
Total Medicare Payment Amount |
12160.95 |
Total Medicare Standardized Payment Amount |
14061.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
689 |
Total Drug Medicare AllowedAmount |
191.18 |
Total Drug Medicare PaymentAmount |
182.26 |
Total Drug Medicare Standardized Payment Amount |
182.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
261 |
Number Of Medicare Beneficiaries With Medical Services |
159 |
Total Medical Submitted Charge Amount |
36738.77 |
Total Medical Medicare Allowed Amount |
15850.56 |
Total Medical Medicare Payment Amount |
11978.69 |
Total Medical Medicare Standardized Payment Amount |
13878.95 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
126 |
Number Of Black or African American Beneficiaries |
16 |
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.113 |