National Provider Identifier [NPI]: |
1194158998 |
Last Name Of The Provider |
ANCHARSKI |
First Name Of The Provider |
LYNETTE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2202 N FORBES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857451412 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
221 |
Number Of Medicare Beneficiaries |
100 |
Total Submitted Charge Amount |
35131 |
Total Medicare Allowed Amount |
12437.67 |
Total Medicare Payment Amount |
8367.74 |
Total Medicare Standardized Payment Amount |
10280.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
235 |
Total Drug Medicare AllowedAmount |
92.95 |
Total Drug Medicare PaymentAmount |
87.23 |
Total Drug Medicare Standardized Payment Amount |
87.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
197 |
Number Of Medicare Beneficiaries With Medical Services |
100 |
Total Medical Submitted Charge Amount |
34896 |
Total Medical Medicare Allowed Amount |
12344.72 |
Total Medical Medicare Payment Amount |
8280.51 |
Total Medical Medicare Standardized Payment Amount |
10193.29 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
85 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
68 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
12 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9453 |