National Provider Identifier [NPI]: |
1760764690 |
Last Name Of The Provider |
LOTT |
First Name Of The Provider |
LORA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
FNP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1135 E BROAD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTICELLO |
Zip Code Of The Provider |
396547682 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
951 |
Number Of Medicare Beneficiaries |
249 |
Total Submitted Charge Amount |
33099.89 |
Total Medicare Allowed Amount |
27338.82 |
Total Medicare Payment Amount |
18905.64 |
Total Medicare Standardized Payment Amount |
24699.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
215 |
Number Of Medicare Beneficiaries With Drug Services |
84 |
Total Drug Submitted ChargeAmount |
402.16 |
Total Drug Medicare AllowedAmount |
246.84 |
Total Drug Medicare PaymentAmount |
206.09 |
Total Drug Medicare Standardized Payment Amount |
206.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
736 |
Number Of Medicare Beneficiaries With Medical Services |
249 |
Total Medical Submitted Charge Amount |
32697.73 |
Total Medical Medicare Allowed Amount |
27091.98 |
Total Medical Medicare Payment Amount |
18699.55 |
Total Medical Medicare Standardized Payment Amount |
24493.82 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
165 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
167 |
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 |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
24 |
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 |
0.8028 |