National Provider Identifier [NPI]: |
1083691802 |
Last Name Of The Provider |
NAVARRO |
First Name Of The Provider |
ROSA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2452 FENTON ST |
Street Address 2 Of The Provider |
SUITE C101 |
City Of The Provider |
CHULA VISTA |
Zip Code Of The Provider |
919143599 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
10912 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
1616979.96 |
Total Medicare Allowed Amount |
371162.63 |
Total Medicare Payment Amount |
282632.01 |
Total Medicare Standardized Payment Amount |
250240.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
7782 |
Number Of Medicare Beneficiaries With Drug Services |
191 |
Total Drug Submitted ChargeAmount |
136562.62 |
Total Drug Medicare AllowedAmount |
18275.89 |
Total Drug Medicare PaymentAmount |
14322.41 |
Total Drug Medicare Standardized Payment Amount |
14322.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
3130 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
1480417.34 |
Total Medical Medicare Allowed Amount |
352886.74 |
Total Medical Medicare Payment Amount |
268309.6 |
Total Medical Medicare Standardized Payment Amount |
235918.52 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
68 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
137 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
89 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6873 |