National Provider Identifier [NPI]: |
1336345420 |
Last Name Of The Provider |
ANDRADE |
First Name Of The Provider |
JOY |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1356 LUSITANA ST |
Street Address 2 Of The Provider |
4TH FLOOR |
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968132421 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
279 |
Number Of Medicare Beneficiaries |
127 |
Total Submitted Charge Amount |
58218.38 |
Total Medicare Allowed Amount |
29042.88 |
Total Medicare Payment Amount |
22428.64 |
Total Medicare Standardized Payment Amount |
21903.07 |
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 |
15 |
Number Of Medical Services |
279 |
Number Of Medicare Beneficiaries With Medical Services |
127 |
Total Medical Submitted Charge Amount |
58218.38 |
Total Medical Medicare Allowed Amount |
29042.88 |
Total Medical Medicare Payment Amount |
22428.64 |
Total Medical Medicare Standardized Payment Amount |
21903.07 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
50 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
55 |
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 |
38 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
70 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
15 |
Percent Of With Schizophrenia Other PsychoticDisorders |
73 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3244 |