National Provider Identifier [NPI]: |
1972767804 |
Last Name Of The Provider |
KEE |
First Name Of The Provider |
MILLICENT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
875 S COLLEGIATE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PARIS |
Zip Code Of The Provider |
754606305 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
662 |
Number Of Medicare Beneficiaries |
496 |
Total Submitted Charge Amount |
67900 |
Total Medicare Allowed Amount |
31446.58 |
Total Medicare Payment Amount |
23003.81 |
Total Medicare Standardized Payment Amount |
28826.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
662 |
Number Of Medicare Beneficiaries With Medical Services |
496 |
Total Medical Submitted Charge Amount |
67900 |
Total Medical Medicare Allowed Amount |
31446.58 |
Total Medical Medicare Payment Amount |
23003.81 |
Total Medical Medicare Standardized Payment Amount |
28826.2 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
259 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
407 |
Number Of Black or African American Beneficiaries |
67 |
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 |
352 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6222 |