National Provider Identifier [NPI]: |
1669476461 |
Last Name Of The Provider |
ROMERO |
First Name Of The Provider |
HAROLD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4727 E. CAMP LOWELL DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857121256 |
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 |
66 |
Number Of Services |
444 |
Number Of Medicare Beneficiaries |
183 |
Total Submitted Charge Amount |
61195.6 |
Total Medicare Allowed Amount |
27034.21 |
Total Medicare Payment Amount |
17995.18 |
Total Medicare Standardized Payment Amount |
21976.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
58 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
816 |
Total Drug Medicare AllowedAmount |
63.27 |
Total Drug Medicare PaymentAmount |
55.61 |
Total Drug Medicare Standardized Payment Amount |
55.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
386 |
Number Of Medicare Beneficiaries With Medical Services |
183 |
Total Medical Submitted Charge Amount |
60379.6 |
Total Medical Medicare Allowed Amount |
26970.94 |
Total Medical Medicare Payment Amount |
17939.57 |
Total Medical Medicare Standardized Payment Amount |
21920.7 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
153 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0774 |