National Provider Identifier [NPI]: |
1649573783 |
Last Name Of The Provider |
CAUSEY |
First Name Of The Provider |
SHERRIKEE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
258 E FORTIFICATION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392022356 |
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 |
17 |
Number Of Services |
272 |
Number Of Medicare Beneficiaries |
51 |
Total Submitted Charge Amount |
6573.2 |
Total Medicare Allowed Amount |
3913.41 |
Total Medicare Payment Amount |
2413.99 |
Total Medicare Standardized Payment Amount |
3442.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
169 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
830 |
Total Drug Medicare AllowedAmount |
275.58 |
Total Drug Medicare PaymentAmount |
261.6 |
Total Drug Medicare Standardized Payment Amount |
261.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
9 |
Number Of Medical Services |
103 |
Number Of Medicare Beneficiaries With Medical Services |
51 |
Total Medical Submitted Charge Amount |
5743.2 |
Total Medical Medicare Allowed Amount |
3637.83 |
Total Medical Medicare Payment Amount |
2152.39 |
Total Medical Medicare Standardized Payment Amount |
3180.99 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
22 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
12 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
0 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
22 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
25 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1381 |