National Provider Identifier [NPI]: |
1508164468 |
Last Name Of The Provider |
GAY |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3805 CHEROKEE ST NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
KENNESAW |
Zip Code Of The Provider |
301442085 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
407 |
Number Of Medicare Beneficiaries |
105 |
Total Submitted Charge Amount |
39459 |
Total Medicare Allowed Amount |
16772.64 |
Total Medicare Payment Amount |
12508.02 |
Total Medicare Standardized Payment Amount |
15067.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
127 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
1906 |
Total Drug Medicare AllowedAmount |
839.76 |
Total Drug Medicare PaymentAmount |
791.01 |
Total Drug Medicare Standardized Payment Amount |
791.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
280 |
Number Of Medicare Beneficiaries With Medical Services |
105 |
Total Medical Submitted Charge Amount |
37553 |
Total Medical Medicare Allowed Amount |
15932.88 |
Total Medical Medicare Payment Amount |
11717.01 |
Total Medical Medicare Standardized Payment Amount |
14276.42 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
72 |
Number Of Male Beneficiaries |
33 |
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 |
13 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8676 |