Medicare Facts for Elesha P. Tidwell, FNP


National Provider Identifier [NPI]: 1558661892
Last Name Of The Provider TIDWELL
First Name Of The Provider ELESHA
Middle Initial Of The Provider P
Credentials Of The Provider FNP
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 830 S GLOSTER ST
Street Address 2 Of The Provider 4TH FLOOR EAST TOWER
City Of The Provider TUPELO
Zip Code Of The Provider 388014934
State Code Of The Provider MS
Country Code Of The Provider US
Provider Type Of The Provider Nurse Practitioner
Medicare Participation Indicator Y
Number Of HCPCS 20
Number Of Services 364
Number Of Medicare Beneficiaries 72
Total Submitted Charge Amount 22332
Total Medicare Allowed Amount 9440.09
Total Medicare Payment Amount 8653.62
Total Medicare Standardized Payment Amount 9713.2
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 20
Number Of Medical Services 364
Number Of Medicare Beneficiaries With Medical Services 72
Total Medical Submitted Charge Amount 22332
Total Medical Medicare Allowed Amount 9440.09
Total Medical Medicare Payment Amount 8653.62
Total Medical Medicare Standardized Payment Amount 9713.2
Average Age Of Beneficiaries 65
Number Of Beneficiaries Age Less65 24
Number Of Beneficiaries Age 65 to 74 34
Number Of Beneficiaries Age 75 to 84 14
Number Of Beneficiaries Age Greater 84 0
Number Of Female Beneficiaries 72
Number Of Male Beneficiaries 0
Number Of Non Hispanic White Beneficiaries 54
Number Of Black or African American Beneficiaries 18
Number Of AsianPacific Islander Beneficiaries 0
Number Of Hispanic Beneficiaries 0
Number Of American Indian Alaska Native Beneficiaries 0
Number Of Beneficiaries With Race Not Else where Classified 0
Number Of Beneficiaries With Medicare Only Entitlement 50
Number Of Beneficiaries With Medicare Medicaid Entitlement 22
Percent Of With Atrial Fibrillation
Percent Of With Alzheimers Disease or Dementia
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 17
Percent Of With Diabetes 29
Percent Of With Hyperlipidemia 53
Percent Of With Hypertension 64
Percent Of With Ischemic Heart Disease 22
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 47
Percent Of With Schizophrenia Other PsychoticDisorders 0
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 0.654

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