National Provider Identifier [NPI]: |
1033451026 |
Last Name Of The Provider |
LOVELL |
First Name Of The Provider |
ALICE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PH.D., RN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
305 KACHUBA CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALTAMONTE SPRINGS |
Zip Code Of The Provider |
327013666 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
1411 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
137590 |
Total Medicare Allowed Amount |
115595.75 |
Total Medicare Payment Amount |
89380.46 |
Total Medicare Standardized Payment Amount |
86505.65 |
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 |
6 |
Number Of Medical Services |
1411 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
137590 |
Total Medical Medicare Allowed Amount |
115595.75 |
Total Medical Medicare Payment Amount |
89380.46 |
Total Medical Medicare Standardized Payment Amount |
86505.65 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
224 |
Number Of Black or African American Beneficiaries |
16 |
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 |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
199 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
74 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
64 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.6623 |