National Provider Identifier [NPI]: |
1992938450 |
Last Name Of The Provider |
HAMMOND |
First Name Of The Provider |
COURTNEY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1208 W 15TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDMOND |
Zip Code Of The Provider |
730133001 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
1004 |
Number Of Medicare Beneficiaries |
233 |
Total Submitted Charge Amount |
98020 |
Total Medicare Allowed Amount |
49549.34 |
Total Medicare Payment Amount |
35192.48 |
Total Medicare Standardized Payment Amount |
45600.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
95 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
1723 |
Total Drug Medicare AllowedAmount |
823.44 |
Total Drug Medicare PaymentAmount |
696.62 |
Total Drug Medicare Standardized Payment Amount |
696.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
909 |
Number Of Medicare Beneficiaries With Medical Services |
233 |
Total Medical Submitted Charge Amount |
96297 |
Total Medical Medicare Allowed Amount |
48725.9 |
Total Medical Medicare Payment Amount |
34495.86 |
Total Medical Medicare Standardized Payment Amount |
44903.71 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.8743 |