National Provider Identifier [NPI]: |
1336273572 |
Last Name Of The Provider |
HAWKINS |
First Name Of The Provider |
ODESSA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
CFNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
106 HIGHLAND WAY |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
391106929 |
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 |
6 |
Number Of Services |
384 |
Number Of Medicare Beneficiaries |
346 |
Total Submitted Charge Amount |
30693 |
Total Medicare Allowed Amount |
20214.49 |
Total Medicare Payment Amount |
15110.04 |
Total Medicare Standardized Payment Amount |
19691.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
6 |
Number Of Medical Services |
384 |
Number Of Medicare Beneficiaries With Medical Services |
346 |
Total Medical Submitted Charge Amount |
30693 |
Total Medical Medicare Allowed Amount |
20214.49 |
Total Medical Medicare Payment Amount |
15110.04 |
Total Medical Medicare Standardized Payment Amount |
19691.1 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
197 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
327 |
Number Of Male Beneficiaries |
19 |
Number Of Non Hispanic White Beneficiaries |
270 |
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 |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
47 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9047 |