National Provider Identifier [NPI]: |
1255396420 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
PATRICIA |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2000 MEADE PARKWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SUFFOLK |
Zip Code Of The Provider |
234344259 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
487 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
60358 |
Total Medicare Allowed Amount |
24822.35 |
Total Medicare Payment Amount |
18180.67 |
Total Medicare Standardized Payment Amount |
22022.76 |
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 |
5 |
Number Of Medical Services |
487 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
60358 |
Total Medical Medicare Allowed Amount |
24822.35 |
Total Medical Medicare Payment Amount |
18180.67 |
Total Medical Medicare Standardized Payment Amount |
22022.76 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
67 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
93 |
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 |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.6876 |