National Provider Identifier [NPI]: |
1376578963 |
Last Name Of The Provider |
VINCENT |
First Name Of The Provider |
TRACY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4801 AMBASSADOR CAFFERY PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
705086917 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
305 |
Number Of Medicare Beneficiaries |
130 |
Total Submitted Charge Amount |
45505 |
Total Medicare Allowed Amount |
25438.47 |
Total Medicare Payment Amount |
19919.98 |
Total Medicare Standardized Payment Amount |
24042.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
305 |
Number Of Medicare Beneficiaries With Medical Services |
130 |
Total Medical Submitted Charge Amount |
45505 |
Total Medical Medicare Allowed Amount |
25438.47 |
Total Medical Medicare Payment Amount |
19919.98 |
Total Medical Medicare Standardized Payment Amount |
24042.9 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
110 |
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 |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
60 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
29 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.4773 |