National Provider Identifier [NPI]: |
1376566091 |
Last Name Of The Provider |
TRENT |
First Name Of The Provider |
SARAH |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
ANP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1040 N JAMES CAMPBELL BLVD STE 108 |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
384012758 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
12401 |
Number Of Medicare Beneficiaries |
304 |
Total Submitted Charge Amount |
1208632 |
Total Medicare Allowed Amount |
338005.15 |
Total Medicare Payment Amount |
311910.83 |
Total Medicare Standardized Payment Amount |
251852.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
551 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
7872 |
Total Drug Medicare AllowedAmount |
1874.03 |
Total Drug Medicare PaymentAmount |
1469.24 |
Total Drug Medicare Standardized Payment Amount |
1469.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
11850 |
Number Of Medicare Beneficiaries With Medical Services |
304 |
Total Medical Submitted Charge Amount |
1200760 |
Total Medical Medicare Allowed Amount |
336131.12 |
Total Medical Medicare Payment Amount |
310441.59 |
Total Medical Medicare Standardized Payment Amount |
250383.31 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
169 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
285 |
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 |
169 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5858 |