National Provider Identifier [NPI]: |
1659345247 |
Last Name Of The Provider |
HOPPER |
First Name Of The Provider |
STACI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
A.P.N. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2708 RIFE MEDICAL LN STE 200 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROGERS |
Zip Code Of The Provider |
727581452 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
378 |
Number Of Medicare Beneficiaries |
261 |
Total Submitted Charge Amount |
50007 |
Total Medicare Allowed Amount |
23692.5 |
Total Medicare Payment Amount |
17074.51 |
Total Medicare Standardized Payment Amount |
22888.94 |
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 |
17 |
Number Of Medical Services |
378 |
Number Of Medicare Beneficiaries With Medical Services |
261 |
Total Medical Submitted Charge Amount |
50007 |
Total Medical Medicare Allowed Amount |
23692.5 |
Total Medical Medicare Payment Amount |
17074.51 |
Total Medical Medicare Standardized Payment Amount |
22888.94 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
117 |
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 |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
30 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
75 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.748 |