National Provider Identifier [NPI]: |
1619936002 |
Last Name Of The Provider |
CASTANEDA |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 N EL DORADO PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857154606 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
18853 |
Number Of Medicare Beneficiaries |
421 |
Total Submitted Charge Amount |
752931.61 |
Total Medicare Allowed Amount |
558466.34 |
Total Medicare Payment Amount |
432062.72 |
Total Medicare Standardized Payment Amount |
442597.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
17276 |
Number Of Medicare Beneficiaries With Drug Services |
126 |
Total Drug Submitted ChargeAmount |
628363.5 |
Total Drug Medicare AllowedAmount |
483585.69 |
Total Drug Medicare PaymentAmount |
376968.34 |
Total Drug Medicare Standardized Payment Amount |
376968.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
1577 |
Number Of Medicare Beneficiaries With Medical Services |
421 |
Total Medical Submitted Charge Amount |
124568.11 |
Total Medical Medicare Allowed Amount |
74880.65 |
Total Medical Medicare Payment Amount |
55094.38 |
Total Medical Medicare Standardized Payment Amount |
65628.97 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
157 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
279 |
Number Of Non Hispanic White Beneficiaries |
365 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
398 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
24 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1739 |