National Provider Identifier [NPI]: |
1598805046 |
Last Name Of The Provider |
GLOVER |
First Name Of The Provider |
SHERRY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 CHEROKEE BLVD |
Street Address 2 Of The Provider |
SUITE 2109 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374053878 |
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 |
10 |
Number Of Services |
889 |
Number Of Medicare Beneficiaries |
190 |
Total Submitted Charge Amount |
222070 |
Total Medicare Allowed Amount |
116739.78 |
Total Medicare Payment Amount |
90456.66 |
Total Medicare Standardized Payment Amount |
111937.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
285 |
Total Drug Medicare AllowedAmount |
132.99 |
Total Drug Medicare PaymentAmount |
129.87 |
Total Drug Medicare Standardized Payment Amount |
129.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
877 |
Number Of Medicare Beneficiaries With Medical Services |
190 |
Total Medical Submitted Charge Amount |
221785 |
Total Medical Medicare Allowed Amount |
116606.79 |
Total Medical Medicare Payment Amount |
90326.79 |
Total Medical Medicare Standardized Payment Amount |
111808.04 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
175 |
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 |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
65 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6391 |