National Provider Identifier [NPI]: |
1346418001 |
Last Name Of The Provider |
WYATT |
First Name Of The Provider |
SHERYL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3220 IRVIN COBB DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PADUCAH |
Zip Code Of The Provider |
420030337 |
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 |
19 |
Number Of Services |
254 |
Number Of Medicare Beneficiaries |
91 |
Total Submitted Charge Amount |
18775 |
Total Medicare Allowed Amount |
7626.77 |
Total Medicare Payment Amount |
4259.03 |
Total Medicare Standardized Payment Amount |
6091.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
113 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
664 |
Total Drug Medicare AllowedAmount |
41.75 |
Total Drug Medicare PaymentAmount |
26.99 |
Total Drug Medicare Standardized Payment Amount |
26.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
141 |
Number Of Medicare Beneficiaries With Medical Services |
91 |
Total Medical Submitted Charge Amount |
18111 |
Total Medical Medicare Allowed Amount |
7585.02 |
Total Medical Medicare Payment Amount |
4232.04 |
Total Medical Medicare Standardized Payment Amount |
6064.97 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
31 |
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 |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.769 |