National Provider Identifier [NPI]: |
1275583254 |
Last Name Of The Provider |
KELLETT |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
133 LITTLETON RD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
WESTFORD |
Zip Code Of The Provider |
018863198 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
275 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
35665.05 |
Total Medicare Allowed Amount |
18521.37 |
Total Medicare Payment Amount |
13621.39 |
Total Medicare Standardized Payment Amount |
15127.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
714.64 |
Total Drug Medicare AllowedAmount |
659.07 |
Total Drug Medicare PaymentAmount |
645.88 |
Total Drug Medicare Standardized Payment Amount |
645.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
258 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
34950.41 |
Total Medical Medicare Allowed Amount |
17862.3 |
Total Medical Medicare Payment Amount |
12975.51 |
Total Medical Medicare Standardized Payment Amount |
14481.25 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
97 |
Number Of Male Beneficiaries |
32 |
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 |
116 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8186 |