National Provider Identifier [NPI]: |
1023308343 |
Last Name Of The Provider |
SNOW |
First Name Of The Provider |
SERENA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1035 WELLINGTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND JUNCTION |
Zip Code Of The Provider |
815018122 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
81 |
Number Of Medicare Beneficiaries |
60 |
Total Submitted Charge Amount |
7335 |
Total Medicare Allowed Amount |
4312.5 |
Total Medicare Payment Amount |
2451.8 |
Total Medicare Standardized Payment Amount |
2985.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
11 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
225 |
Total Drug Medicare AllowedAmount |
163.48 |
Total Drug Medicare PaymentAmount |
160.2 |
Total Drug Medicare Standardized Payment Amount |
160.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
70 |
Number Of Medicare Beneficiaries With Medical Services |
60 |
Total Medical Submitted Charge Amount |
7110 |
Total Medical Medicare Allowed Amount |
4149.02 |
Total Medical Medicare Payment Amount |
2291.6 |
Total Medical Medicare Standardized Payment Amount |
2825.52 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
22 |
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0683 |