National Provider Identifier [NPI]: |
1306117007 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
98-1005 MOANALUA RD |
Street Address 2 Of The Provider |
#400 |
City Of The Provider |
AIEA |
Zip Code Of The Provider |
967014777 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
49 |
Number Of Medicare Beneficiaries |
29 |
Total Submitted Charge Amount |
2172.84 |
Total Medicare Allowed Amount |
2028.4 |
Total Medicare Payment Amount |
1692.92 |
Total Medicare Standardized Payment Amount |
1891.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
523.84 |
Total Drug Medicare AllowedAmount |
523.84 |
Total Drug Medicare PaymentAmount |
513.36 |
Total Drug Medicare Standardized Payment Amount |
513.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
33 |
Number Of Medicare Beneficiaries With Medical Services |
29 |
Total Medical Submitted Charge Amount |
1649 |
Total Medical Medicare Allowed Amount |
1504.56 |
Total Medical Medicare Payment Amount |
1179.56 |
Total Medical Medicare Standardized Payment Amount |
1378.01 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
29 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
0 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6014 |