National Provider Identifier [NPI]: |
1427000645 |
Last Name Of The Provider |
SAMMER |
First Name Of The Provider |
BETTY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 MEMORIAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLA VISTA |
Zip Code Of The Provider |
727141847 |
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 |
85 |
Number Of Services |
2093 |
Number Of Medicare Beneficiaries |
275 |
Total Submitted Charge Amount |
172204 |
Total Medicare Allowed Amount |
70409.09 |
Total Medicare Payment Amount |
49246.6 |
Total Medicare Standardized Payment Amount |
62450.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
135 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
3702 |
Total Drug Medicare AllowedAmount |
2570.31 |
Total Drug Medicare PaymentAmount |
2030.81 |
Total Drug Medicare Standardized Payment Amount |
2030.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
81 |
Number Of Medical Services |
1958 |
Number Of Medicare Beneficiaries With Medical Services |
275 |
Total Medical Submitted Charge Amount |
168502 |
Total Medical Medicare Allowed Amount |
67838.78 |
Total Medical Medicare Payment Amount |
47215.79 |
Total Medical Medicare Standardized Payment Amount |
60419.39 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
61 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0618 |