National Provider Identifier [NPI]: |
1487672465 |
Last Name Of The Provider |
CLAYTON |
First Name Of The Provider |
TAMMY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
ACNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5 MOBILE INFIRMARY CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOBILE |
Zip Code Of The Provider |
366073513 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
690 |
Number Of Medicare Beneficiaries |
298 |
Total Submitted Charge Amount |
68381 |
Total Medicare Allowed Amount |
32501.78 |
Total Medicare Payment Amount |
23080.46 |
Total Medicare Standardized Payment Amount |
29962.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
161 |
Number Of Medicare Beneficiaries With Drug Services |
39 |
Total Drug Submitted ChargeAmount |
2446 |
Total Drug Medicare AllowedAmount |
261.39 |
Total Drug Medicare PaymentAmount |
151.59 |
Total Drug Medicare Standardized Payment Amount |
151.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
529 |
Number Of Medicare Beneficiaries With Medical Services |
298 |
Total Medical Submitted Charge Amount |
65935 |
Total Medical Medicare Allowed Amount |
32240.39 |
Total Medical Medicare Payment Amount |
22928.87 |
Total Medical Medicare Standardized Payment Amount |
29810.57 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
210 |
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 |
219 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7712 |