National Provider Identifier [NPI]: |
1831173012 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1311 N ARLINGTON AVE |
Street Address 2 Of The Provider |
101 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462193286 |
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 |
22 |
Number Of Services |
826 |
Number Of Medicare Beneficiaries |
105 |
Total Submitted Charge Amount |
153706 |
Total Medicare Allowed Amount |
92107.14 |
Total Medicare Payment Amount |
69334.59 |
Total Medicare Standardized Payment Amount |
86393.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
472 |
Total Drug Medicare AllowedAmount |
342.35 |
Total Drug Medicare PaymentAmount |
334.76 |
Total Drug Medicare Standardized Payment Amount |
334.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
802 |
Number Of Medicare Beneficiaries With Medical Services |
105 |
Total Medical Submitted Charge Amount |
153234 |
Total Medical Medicare Allowed Amount |
91764.79 |
Total Medical Medicare Payment Amount |
68999.83 |
Total Medical Medicare Standardized Payment Amount |
86058.27 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
23 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
70 |
Number Of Black or African American Beneficiaries |
35 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
49 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
41 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.7965 |