National Provider Identifier [NPI]: |
1669645180 |
Last Name Of The Provider |
CARVER |
First Name Of The Provider |
LEA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4800 FREDERICKSBURG RD |
Street Address 2 Of The Provider |
STE 127 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782293628 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1454.5 |
Number Of Medicare Beneficiaries |
321 |
Total Submitted Charge Amount |
147933.38 |
Total Medicare Allowed Amount |
104510.52 |
Total Medicare Payment Amount |
81768.66 |
Total Medicare Standardized Payment Amount |
99522.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
94.5 |
Number Of Medicare Beneficiaries With Drug Services |
81 |
Total Drug Submitted ChargeAmount |
1719.06 |
Total Drug Medicare AllowedAmount |
1612.12 |
Total Drug Medicare PaymentAmount |
1525.67 |
Total Drug Medicare Standardized Payment Amount |
1525.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1360 |
Number Of Medicare Beneficiaries With Medical Services |
321 |
Total Medical Submitted Charge Amount |
146214.32 |
Total Medical Medicare Allowed Amount |
102898.4 |
Total Medical Medicare Payment Amount |
80242.99 |
Total Medical Medicare Standardized Payment Amount |
97996.74 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
207 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
129 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
156 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
148 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
173 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.5098 |