National Provider Identifier [NPI]: |
1629010848 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
ANDRES |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
911 S WASHINGTON ST |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
KENNEWICK |
Zip Code Of The Provider |
993365600 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
3076 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
192244 |
Total Medicare Allowed Amount |
93301.02 |
Total Medicare Payment Amount |
66376.87 |
Total Medicare Standardized Payment Amount |
75348.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
1811 |
Number Of Medicare Beneficiaries With Drug Services |
124 |
Total Drug Submitted ChargeAmount |
44028 |
Total Drug Medicare AllowedAmount |
30811.56 |
Total Drug Medicare PaymentAmount |
22667.21 |
Total Drug Medicare Standardized Payment Amount |
22667.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
1265 |
Number Of Medicare Beneficiaries With Medical Services |
313 |
Total Medical Submitted Charge Amount |
148216 |
Total Medical Medicare Allowed Amount |
62489.46 |
Total Medical Medicare Payment Amount |
43709.66 |
Total Medical Medicare Standardized Payment Amount |
52681.18 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
256 |
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 |
228 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1156 |