National Provider Identifier [NPI]: |
1285967547 |
Last Name Of The Provider |
RHINEWALT |
First Name Of The Provider |
TRACY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MSN FNP BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
971 LAKELAND DR |
Street Address 2 Of The Provider |
SUITE 657 |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164643 |
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 |
18 |
Number Of Services |
1676 |
Number Of Medicare Beneficiaries |
347 |
Total Submitted Charge Amount |
224680 |
Total Medicare Allowed Amount |
135194.29 |
Total Medicare Payment Amount |
102383.58 |
Total Medicare Standardized Payment Amount |
129040.41 |
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 |
65 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
276 |
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 |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3615 |