National Provider Identifier [NPI]: |
1679729248 |
Last Name Of The Provider |
CHRISTOPHER |
First Name Of The Provider |
GINA |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
108 N. PALM AVE. |
Street Address 2 Of The Provider |
|
City Of The Provider |
PALATKA |
Zip Code Of The Provider |
321772626 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
404 |
Number Of Medicare Beneficiaries |
54 |
Total Submitted Charge Amount |
13421 |
Total Medicare Allowed Amount |
10519.34 |
Total Medicare Payment Amount |
8206.16 |
Total Medicare Standardized Payment Amount |
9059.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
308 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
5151 |
Total Drug Medicare AllowedAmount |
4433.36 |
Total Drug Medicare PaymentAmount |
3493.33 |
Total Drug Medicare Standardized Payment Amount |
3493.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
96 |
Number Of Medicare Beneficiaries With Medical Services |
54 |
Total Medical Submitted Charge Amount |
8270 |
Total Medical Medicare Allowed Amount |
6085.98 |
Total Medical Medicare Payment Amount |
4712.83 |
Total Medical Medicare Standardized Payment Amount |
5565.85 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
24 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
30 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9156 |