National Provider Identifier [NPI]: |
1881705978 |
Last Name Of The Provider |
PACQUING |
First Name Of The Provider |
MARICAR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
110 SUTTER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941044002 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Osteopathic Manipulative Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
113 |
Number Of Medicare Beneficiaries |
45 |
Total Submitted Charge Amount |
25604.42 |
Total Medicare Allowed Amount |
9770.8 |
Total Medicare Payment Amount |
7656.97 |
Total Medicare Standardized Payment Amount |
7399.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
21 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1534.35 |
Total Drug Medicare AllowedAmount |
600.98 |
Total Drug Medicare PaymentAmount |
588.96 |
Total Drug Medicare Standardized Payment Amount |
588.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
92 |
Number Of Medicare Beneficiaries With Medical Services |
45 |
Total Medical Submitted Charge Amount |
24070.07 |
Total Medical Medicare Allowed Amount |
9169.82 |
Total Medical Medicare Payment Amount |
7068.01 |
Total Medical Medicare Standardized Payment Amount |
6810.46 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
24 |
Number Of Male Beneficiaries |
21 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
0 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
36 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.8042 |