National Provider Identifier [NPI]: |
1396185542 |
Last Name Of The Provider |
CALL |
First Name Of The Provider |
JANA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
FNP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
351 PEOPLES DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PONTOTOC |
Zip Code Of The Provider |
388638990 |
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 |
86 |
Number Of Services |
4362 |
Number Of Medicare Beneficiaries |
367 |
Total Submitted Charge Amount |
164281 |
Total Medicare Allowed Amount |
69897.98 |
Total Medicare Payment Amount |
51725.55 |
Total Medicare Standardized Payment Amount |
60196.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
18 |
Number Of Drug Services |
2631 |
Number Of Medicare Beneficiaries With Drug Services |
280 |
Total Drug Submitted ChargeAmount |
28611 |
Total Drug Medicare AllowedAmount |
2633.38 |
Total Drug Medicare PaymentAmount |
2091.92 |
Total Drug Medicare Standardized Payment Amount |
2091.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
68 |
Number Of Medical Services |
1731 |
Number Of Medicare Beneficiaries With Medical Services |
367 |
Total Medical Submitted Charge Amount |
135670 |
Total Medical Medicare Allowed Amount |
67264.6 |
Total Medical Medicare Payment Amount |
49633.63 |
Total Medical Medicare Standardized Payment Amount |
58104.38 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
254 |
Number Of Male Beneficiaries |
113 |
Number Of Non Hispanic White Beneficiaries |
330 |
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 |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
145 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
5 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8721 |