National Provider Identifier [NPI]: |
1164501649 |
Last Name Of The Provider |
WISWALL |
First Name Of The Provider |
CLAIRE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2320 BATH ST STE 205 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA BARBARA |
Zip Code Of The Provider |
931055313 |
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 |
27 |
Number Of Services |
1047 |
Number Of Medicare Beneficiaries |
209 |
Total Submitted Charge Amount |
40695.1 |
Total Medicare Allowed Amount |
31921.45 |
Total Medicare Payment Amount |
23335.11 |
Total Medicare Standardized Payment Amount |
26053.38 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
194 |
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
0.9357 |