National Provider Identifier [NPI]: |
1902966336 |
Last Name Of The Provider |
BIANCHI |
First Name Of The Provider |
TERRI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
305 CLYDE MORRIS BLVD |
Street Address 2 Of The Provider |
SUITE 150 |
City Of The Provider |
ORMOND BEACH |
Zip Code Of The Provider |
321748181 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
2762 |
Number Of Medicare Beneficiaries |
677 |
Total Submitted Charge Amount |
268840 |
Total Medicare Allowed Amount |
161336.61 |
Total Medicare Payment Amount |
116187.87 |
Total Medicare Standardized Payment Amount |
137069.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
44 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
6578 |
Total Drug Medicare AllowedAmount |
5498.9 |
Total Drug Medicare PaymentAmount |
4143.57 |
Total Drug Medicare Standardized Payment Amount |
4143.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
2718 |
Number Of Medicare Beneficiaries With Medical Services |
677 |
Total Medical Submitted Charge Amount |
262262 |
Total Medical Medicare Allowed Amount |
155837.71 |
Total Medical Medicare Payment Amount |
112044.3 |
Total Medical Medicare Standardized Payment Amount |
132925.93 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
375 |
Number Of Beneficiaries Age 75 to 84 |
214 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
381 |
Number Of Male Beneficiaries |
296 |
Number Of Non Hispanic White Beneficiaries |
659 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.906 |