National Provider Identifier [NPI]: |
1548555378 |
Last Name Of The Provider |
PRICE |
First Name Of The Provider |
VIRGINIA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
APN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 S TIMBERLANE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
EL DORADO |
Zip Code Of The Provider |
717306990 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
730 |
Number Of Medicare Beneficiaries |
373 |
Total Submitted Charge Amount |
126923 |
Total Medicare Allowed Amount |
68184.18 |
Total Medicare Payment Amount |
49353.82 |
Total Medicare Standardized Payment Amount |
65507.89 |
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 |
4 |
Number Of Medical Services |
730 |
Number Of Medicare Beneficiaries With Medical Services |
373 |
Total Medical Submitted Charge Amount |
126923 |
Total Medical Medicare Allowed Amount |
68184.18 |
Total Medical Medicare Payment Amount |
49353.82 |
Total Medical Medicare Standardized Payment Amount |
65507.89 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
187 |
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 |
309 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0974 |