National Provider Identifier [NPI]: |
1801152095 |
Last Name Of The Provider |
KAMP |
First Name Of The Provider |
JAMI |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MSN, RN, FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1855 S. MAIN STREET |
Street Address 2 Of The Provider |
SUITE A, HEART & VASCULAR CENTER |
City Of The Provider |
GOSHEN |
Zip Code Of The Provider |
465264723 |
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 |
10 |
Number Of Services |
373 |
Number Of Medicare Beneficiaries |
262 |
Total Submitted Charge Amount |
62587 |
Total Medicare Allowed Amount |
29080.4 |
Total Medicare Payment Amount |
21753.99 |
Total Medicare Standardized Payment Amount |
27602.12 |
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 |
10 |
Number Of Medical Services |
373 |
Number Of Medicare Beneficiaries With Medical Services |
262 |
Total Medical Submitted Charge Amount |
62587 |
Total Medical Medicare Allowed Amount |
29080.4 |
Total Medical Medicare Payment Amount |
21753.99 |
Total Medical Medicare Standardized Payment Amount |
27602.12 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
121 |
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4048 |