National Provider Identifier [NPI]: |
1245537752 |
Last Name Of The Provider |
PAGE |
First Name Of The Provider |
COREY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
621 OLD HICKORY BLVD |
Street Address 2 Of The Provider |
SUITE G |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
383052907 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
5193 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
489303 |
Total Medicare Allowed Amount |
132976.14 |
Total Medicare Payment Amount |
102250.9 |
Total Medicare Standardized Payment Amount |
125595.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
18 |
Number Of Drug Services |
604 |
Number Of Medicare Beneficiaries With Drug Services |
146 |
Total Drug Submitted ChargeAmount |
18742 |
Total Drug Medicare AllowedAmount |
3692.52 |
Total Drug Medicare PaymentAmount |
3331.08 |
Total Drug Medicare Standardized Payment Amount |
3331.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
4589 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
470561 |
Total Medical Medicare Allowed Amount |
129283.62 |
Total Medical Medicare Payment Amount |
98919.82 |
Total Medical Medicare Standardized Payment Amount |
122264.54 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
163 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
161 |
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 |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
152 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
5 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.274 |