National Provider Identifier [NPI]: |
1841288107 |
Last Name Of The Provider |
FANNING |
First Name Of The Provider |
CARA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5380 S RAINBOW BLVD |
Street Address 2 Of The Provider |
SUITE 110 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891181877 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
2473 |
Number Of Medicare Beneficiaries |
376 |
Total Submitted Charge Amount |
666650 |
Total Medicare Allowed Amount |
232724.6 |
Total Medicare Payment Amount |
181690.54 |
Total Medicare Standardized Payment Amount |
178370.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
2473 |
Number Of Medicare Beneficiaries With Medical Services |
376 |
Total Medical Submitted Charge Amount |
666650 |
Total Medical Medicare Allowed Amount |
232724.6 |
Total Medical Medicare Payment Amount |
181690.54 |
Total Medical Medicare Standardized Payment Amount |
178370.06 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
146 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
180 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
198 |
Number Of Black or African American Beneficiaries |
96 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
55 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
205 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
53 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
28 |
Average HCC Risk Score Of Beneficiaries |
4.2795 |