National Provider Identifier [NPI]: |
1578751053 |
Last Name Of The Provider |
KACZMAREK |
First Name Of The Provider |
ANYA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1595 E RIVER RD |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857185981 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2168 |
Number Of Medicare Beneficiaries |
538 |
Total Submitted Charge Amount |
147685 |
Total Medicare Allowed Amount |
89401.51 |
Total Medicare Payment Amount |
68387.03 |
Total Medicare Standardized Payment Amount |
78805.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
68 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
346 |
Total Drug Medicare AllowedAmount |
124.04 |
Total Drug Medicare PaymentAmount |
97.23 |
Total Drug Medicare Standardized Payment Amount |
97.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
2100 |
Number Of Medicare Beneficiaries With Medical Services |
538 |
Total Medical Submitted Charge Amount |
147339 |
Total Medical Medicare Allowed Amount |
89277.47 |
Total Medical Medicare Payment Amount |
68289.8 |
Total Medical Medicare Standardized Payment Amount |
78708.38 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
304 |
Number Of Beneficiaries Age 75 to 84 |
176 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
341 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
511 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
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 |
9 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.8112 |