National Provider Identifier [NPI]: |
1710277850 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
NANCY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8800 LONG POINT RD |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770553025 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
281 |
Number Of Medicare Beneficiaries |
59 |
Total Submitted Charge Amount |
21341 |
Total Medicare Allowed Amount |
10628.28 |
Total Medicare Payment Amount |
7140.72 |
Total Medicare Standardized Payment Amount |
8496.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
73 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
565 |
Total Drug Medicare AllowedAmount |
76.17 |
Total Drug Medicare PaymentAmount |
58.57 |
Total Drug Medicare Standardized Payment Amount |
58.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
208 |
Number Of Medicare Beneficiaries With Medical Services |
59 |
Total Medical Submitted Charge Amount |
20776 |
Total Medical Medicare Allowed Amount |
10552.11 |
Total Medical Medicare Payment Amount |
7082.15 |
Total Medical Medicare Standardized Payment Amount |
8438.06 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
23 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
0 |
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 |
53 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0935 |