Medicare Facts for Diane K. Jackson, APRN


National Provider Identifier [NPI]: 1487694089
Last Name Of The Provider JACKSON
First Name Of The Provider DIANE
Middle Initial Of The Provider K
Credentials Of The Provider A.P.R.N.
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 121 15TH AVE
Street Address 2 Of The Provider
City Of The Provider FRANKLIN
Zip Code Of The Provider 689391043
State Code Of The Provider NE
Country Code Of The Provider US
Provider Type Of The Provider Nurse Practitioner
Medicare Participation Indicator Y
Number Of HCPCS 22
Number Of Services 142
Number Of Medicare Beneficiaries 100
Total Submitted Charge Amount 18893
Total Medicare Allowed Amount 8341.45
Total Medicare Payment Amount 5785.09
Total Medicare Standardized Payment Amount 7023.97
Drug Suppress Indicator *
Number Of HCPCS Associated With Drug Services
Number Of Drug Services
Number Of Medicare Beneficiaries With Drug Services
Total Drug Submitted ChargeAmount
Total Drug Medicare AllowedAmount
Total Drug Medicare PaymentAmount
Total Drug Medicare Standardized Payment Amount
Medical SuppressIndicator #
Number Of HCPCS Associated With MedicalServices
Number Of Medical Services
Number Of Medicare Beneficiaries With Medical Services
Total Medical Submitted Charge Amount
Total Medical Medicare Allowed Amount
Total Medical Medicare Payment Amount
Total Medical Medicare Standardized Payment Amount
Average Age Of Beneficiaries 69
Number Of Beneficiaries Age Less65 27
Number Of Beneficiaries Age 65 to 74 34
Number Of Beneficiaries Age 75 to 84 26
Number Of Beneficiaries Age Greater 84 13
Number Of Female Beneficiaries 62
Number Of Male Beneficiaries 38
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 73
Number Of Beneficiaries With Medicare Medicaid Entitlement 27
Percent Of With Atrial Fibrillation 14
Percent Of With Alzheimers Disease or Dementia 11
Percent Of With Asthma
Percent Of With Cancer 16
Percent Of With Heart Failure 16
Percent Of With Chronic Kidney Disease 21
Percent Of With Chronic Obstructive Pulmonary Disease 19
Percent Of With Depression 24
Percent Of With Diabetes 27
Percent Of With Hyperlipidemia 48
Percent Of With Hypertension 60
Percent Of With Ischemic Heart Disease 31
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 34
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 0.981

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