National Provider Identifier [NPI]: |
1346290376 |
Last Name Of The Provider |
MARLOWE |
First Name Of The Provider |
SALLY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2221 KENT PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEARWATER |
Zip Code Of The Provider |
337646624 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
2171 |
Number Of Medicare Beneficiaries |
66 |
Total Submitted Charge Amount |
110391 |
Total Medicare Allowed Amount |
39242.79 |
Total Medicare Payment Amount |
29243.53 |
Total Medicare Standardized Payment Amount |
31240.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1227 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
6356 |
Total Drug Medicare AllowedAmount |
324.06 |
Total Drug Medicare PaymentAmount |
250.69 |
Total Drug Medicare Standardized Payment Amount |
250.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
944 |
Number Of Medicare Beneficiaries With Medical Services |
66 |
Total Medical Submitted Charge Amount |
104035 |
Total Medical Medicare Allowed Amount |
38918.73 |
Total Medical Medicare Payment Amount |
28992.84 |
Total Medical Medicare Standardized Payment Amount |
30989.4 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
25 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
16 |
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 |
49 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
42 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2823 |