National Provider Identifier [NPI]: |
1730520743 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
LORIE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1635 HIGHWAY 31 NW STE C |
Street Address 2 Of The Provider |
|
City Of The Provider |
HARTSELLE |
Zip Code Of The Provider |
356404426 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
139 |
Number Of Medicare Beneficiaries |
44 |
Total Submitted Charge Amount |
5105 |
Total Medicare Allowed Amount |
3083.99 |
Total Medicare Payment Amount |
2147.61 |
Total Medicare Standardized Payment Amount |
2719.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
59 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
787 |
Total Drug Medicare AllowedAmount |
274.56 |
Total Drug Medicare PaymentAmount |
225.2 |
Total Drug Medicare Standardized Payment Amount |
225.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
80 |
Number Of Medicare Beneficiaries With Medical Services |
44 |
Total Medical Submitted Charge Amount |
4318 |
Total Medical Medicare Allowed Amount |
2809.43 |
Total Medical Medicare Payment Amount |
1922.41 |
Total Medical Medicare Standardized Payment Amount |
2494.03 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
20 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
23 |
Number Of Male Beneficiaries |
21 |
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 |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.865 |