National Provider Identifier [NPI]: |
1063468338 |
Last Name Of The Provider |
BOSMA |
First Name Of The Provider |
CECILY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4151 FOOTHILL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA BARBARA |
Zip Code Of The Provider |
931101110 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1531 |
Number Of Medicare Beneficiaries |
443 |
Total Submitted Charge Amount |
286503.25 |
Total Medicare Allowed Amount |
89184.75 |
Total Medicare Payment Amount |
63857.44 |
Total Medicare Standardized Payment Amount |
70105.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
270 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
50318 |
Total Drug Medicare AllowedAmount |
16572.97 |
Total Drug Medicare PaymentAmount |
11904.23 |
Total Drug Medicare Standardized Payment Amount |
11904.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
1261 |
Number Of Medicare Beneficiaries With Medical Services |
443 |
Total Medical Submitted Charge Amount |
236185.25 |
Total Medical Medicare Allowed Amount |
72611.78 |
Total Medical Medicare Payment Amount |
51953.21 |
Total Medical Medicare Standardized Payment Amount |
58201.15 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
167 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
294 |
Number Of Non Hispanic White Beneficiaries |
351 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
67 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
393 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1236 |