National Provider Identifier [NPI]: |
1033167218 |
Last Name Of The Provider |
BACO |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22 WEST UNDERWOOD ST |
Street Address 2 Of The Provider |
4TH FLOOR |
City Of The Provider |
ORLANDO |
Zip Code Of The Provider |
32806 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
533 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
55690 |
Total Medicare Allowed Amount |
43845.16 |
Total Medicare Payment Amount |
33964.78 |
Total Medicare Standardized Payment Amount |
40812.17 |
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 |
3 |
Number Of Medical Services |
533 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
55690 |
Total Medical Medicare Allowed Amount |
43845.16 |
Total Medical Medicare Payment Amount |
33964.78 |
Total Medical Medicare Standardized Payment Amount |
40812.17 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
123 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
37 |
Percent Of With Alzheimers Disease or Dementia |
69 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
2.3408 |