National Provider Identifier [NPI]: |
1962457515 |
Last Name Of The Provider |
KEAGLE |
First Name Of The Provider |
RITA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1401 MADISON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COVINGTON |
Zip Code Of The Provider |
410113313 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
821 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
49649 |
Total Medicare Allowed Amount |
25477.02 |
Total Medicare Payment Amount |
18860.12 |
Total Medicare Standardized Payment Amount |
23381.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
70 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
2221 |
Total Drug Medicare AllowedAmount |
1021.2 |
Total Drug Medicare PaymentAmount |
990.82 |
Total Drug Medicare Standardized Payment Amount |
990.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
751 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
47428 |
Total Medical Medicare Allowed Amount |
24455.82 |
Total Medical Medicare Payment Amount |
17869.3 |
Total Medical Medicare Standardized Payment Amount |
22390.42 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
57 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.071 |