National Provider Identifier [NPI]: |
1063783504 |
Last Name Of The Provider |
BROOKS |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
CRNP, FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
19201 MONTGOMERY VILLAGE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAITHERSBURG |
Zip Code Of The Provider |
208865027 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
203 |
Number Of Medicare Beneficiaries |
114 |
Total Submitted Charge Amount |
24593.44 |
Total Medicare Allowed Amount |
16936.42 |
Total Medicare Payment Amount |
12093.41 |
Total Medicare Standardized Payment Amount |
13677.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
165.39 |
Total Drug Medicare AllowedAmount |
109.86 |
Total Drug Medicare PaymentAmount |
85.69 |
Total Drug Medicare Standardized Payment Amount |
85.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
181 |
Number Of Medicare Beneficiaries With Medical Services |
114 |
Total Medical Submitted Charge Amount |
24428.05 |
Total Medical Medicare Allowed Amount |
16826.56 |
Total Medical Medicare Payment Amount |
12007.72 |
Total Medical Medicare Standardized Payment Amount |
13591.65 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
39 |
Number Of Non Hispanic White Beneficiaries |
86 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9932 |