National Provider Identifier [NPI]: |
1346220191 |
Last Name Of The Provider |
HANNON |
First Name Of The Provider |
VIVIAN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1241 BLOUNT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GUNTERSVILLE |
Zip Code Of The Provider |
359761831 |
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 |
52 |
Number Of Services |
2162 |
Number Of Medicare Beneficiaries |
346 |
Total Submitted Charge Amount |
40478 |
Total Medicare Allowed Amount |
25568.03 |
Total Medicare Payment Amount |
22524.76 |
Total Medicare Standardized Payment Amount |
25914.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
583 |
Number Of Medicare Beneficiaries With Drug Services |
138 |
Total Drug Submitted ChargeAmount |
7699 |
Total Drug Medicare AllowedAmount |
5414.36 |
Total Drug Medicare PaymentAmount |
5135.21 |
Total Drug Medicare Standardized Payment Amount |
5135.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
1579 |
Number Of Medicare Beneficiaries With Medical Services |
346 |
Total Medical Submitted Charge Amount |
32779 |
Total Medical Medicare Allowed Amount |
20153.67 |
Total Medical Medicare Payment Amount |
17389.55 |
Total Medical Medicare Standardized Payment Amount |
20778.96 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
149 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
315 |
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
205 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0837 |