| National Provider Identifier [NPI]: | 1700842630 |
| Last Name Of The Provider | COLUSSY |
| First Name Of The Provider | ANDREA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2001 W ORANGE GROVE RD STE 312 |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857041141 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 607 |
| Number Of Medicare Beneficiaries | 127 |
| Total Submitted Charge Amount | 101327 |
| Total Medicare Allowed Amount | 80785.72 |
| Total Medicare Payment Amount | 59767.75 |
| Total Medicare Standardized Payment Amount | 72790.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 552 |
| Total Drug Medicare AllowedAmount | 471.38 |
| Total Drug Medicare PaymentAmount | 461.1 |
| Total Drug Medicare Standardized Payment Amount | 461.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 591 |
| Number Of Medicare Beneficiaries With Medical Services | 127 |
| Total Medical Submitted Charge Amount | 100775 |
| Total Medical Medicare Allowed Amount | 80314.34 |
| Total Medical Medicare Payment Amount | 59306.65 |
| Total Medical Medicare Standardized Payment Amount | 72329.81 |
| Average Age Of Beneficiaries | 89 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 91 |
| Number Of Male Beneficiaries | 36 |
| 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 | 127 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 35 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.976 |