National Provider Identifier [NPI]: |
1962565093 |
Last Name Of The Provider |
GARZA |
First Name Of The Provider |
OLIVIA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5301 E GRANT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857122805 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1776 |
Number Of Medicare Beneficiaries |
526 |
Total Submitted Charge Amount |
178830 |
Total Medicare Allowed Amount |
60175.68 |
Total Medicare Payment Amount |
47064.06 |
Total Medicare Standardized Payment Amount |
39095.16 |
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 |
29 |
Number Of Medical Services |
1776 |
Number Of Medicare Beneficiaries With Medical Services |
526 |
Total Medical Submitted Charge Amount |
178830 |
Total Medical Medicare Allowed Amount |
60175.68 |
Total Medical Medicare Payment Amount |
47064.06 |
Total Medical Medicare Standardized Payment Amount |
39095.16 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
266 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
444 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
63 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
428 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6377 |