National Provider Identifier [NPI]: |
1598878548 |
Last Name Of The Provider |
LYMAN |
First Name Of The Provider |
KELLY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1755 E 61ST ST N |
Street Address 2 Of The Provider |
|
City Of The Provider |
PARK CITY |
Zip Code Of The Provider |
672191917 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
736 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
59976 |
Total Medicare Allowed Amount |
25798.75 |
Total Medicare Payment Amount |
17607.55 |
Total Medicare Standardized Payment Amount |
18850.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
216 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
6123 |
Total Drug Medicare AllowedAmount |
2585.9 |
Total Drug Medicare PaymentAmount |
2122.33 |
Total Drug Medicare Standardized Payment Amount |
2122.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
520 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
53853 |
Total Medical Medicare Allowed Amount |
23212.85 |
Total Medical Medicare Payment Amount |
15485.22 |
Total Medical Medicare Standardized Payment Amount |
16728.1 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
44 |
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 |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
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 |
16 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.084 |