National Provider Identifier [NPI]: |
1366883035 |
Last Name Of The Provider |
ISAH |
First Name Of The Provider |
CHARLOTTE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4012 AUTUMNWOOD LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
HEARTLAND |
Zip Code Of The Provider |
751268299 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
1933 |
Number Of Medicare Beneficiaries |
256 |
Total Submitted Charge Amount |
171355.81 |
Total Medicare Allowed Amount |
106534.69 |
Total Medicare Payment Amount |
78134.34 |
Total Medicare Standardized Payment Amount |
96476.54 |
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 |
5 |
Number Of Medical Services |
1933 |
Number Of Medicare Beneficiaries With Medical Services |
256 |
Total Medical Submitted Charge Amount |
171355.81 |
Total Medical Medicare Allowed Amount |
106534.69 |
Total Medical Medicare Payment Amount |
78134.34 |
Total Medical Medicare Standardized Payment Amount |
96476.54 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
180 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
207 |
Number Of Black or African American Beneficiaries |
36 |
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 |
104 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
152 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
67 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.1038 |