National Provider Identifier [NPI]: |
1114336989 |
Last Name Of The Provider |
O'KEEFE |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
R.N., A.G.N.P |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8550 BROADWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MERRILLVILLE |
Zip Code Of The Provider |
464107173 |
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 |
11 |
Number Of Services |
88 |
Number Of Medicare Beneficiaries |
49 |
Total Submitted Charge Amount |
7875 |
Total Medicare Allowed Amount |
5209.52 |
Total Medicare Payment Amount |
4241.04 |
Total Medicare Standardized Payment Amount |
5091.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
685 |
Total Drug Medicare AllowedAmount |
355.4 |
Total Drug Medicare PaymentAmount |
347.93 |
Total Drug Medicare Standardized Payment Amount |
347.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
71 |
Number Of Medicare Beneficiaries With Medical Services |
49 |
Total Medical Submitted Charge Amount |
7190 |
Total Medical Medicare Allowed Amount |
4854.12 |
Total Medical Medicare Payment Amount |
3893.11 |
Total Medical Medicare Standardized Payment Amount |
4743.54 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
25 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
32 |
Number Of Male Beneficiaries |
17 |
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 |
22 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
43 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.1542 |