National Provider Identifier [NPI]: |
1538428875 |
Last Name Of The Provider |
HENDRESS |
First Name Of The Provider |
ERICA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
523 SOUTH STATE ROAD 67 |
Street Address 2 Of The Provider |
MINUTE CLINIC |
City Of The Provider |
MOORESVILLE |
Zip Code Of The Provider |
461584529 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
623 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
26826.86 |
Total Medicare Allowed Amount |
24023.13 |
Total Medicare Payment Amount |
18407.97 |
Total Medicare Standardized Payment Amount |
21942.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
216 |
Number Of Medicare Beneficiaries With Drug Services |
203 |
Total Drug Submitted ChargeAmount |
6664.86 |
Total Drug Medicare AllowedAmount |
6664.86 |
Total Drug Medicare PaymentAmount |
6440.01 |
Total Drug Medicare Standardized Payment Amount |
6440.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
407 |
Number Of Medicare Beneficiaries With Medical Services |
329 |
Total Medical Submitted Charge Amount |
20162 |
Total Medical Medicare Allowed Amount |
17358.27 |
Total Medical Medicare Payment Amount |
11967.96 |
Total Medical Medicare Standardized Payment Amount |
15502.73 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
119 |
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 |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7916 |