Medicare Facts for Sally E. Decastro-Tilsen, PA


National Provider Identifier [NPI]: 1023282019
Last Name Of The Provider DECASTRO-TILSEN
First Name Of The Provider SALLY
Middle Initial Of The Provider E
Credentials Of The Provider P.A.
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 400 NEWPORT CENTER DR STE 701
Street Address 2 Of The Provider
City Of The Provider NEWPORT BEACH
Zip Code Of The Provider 926607608
State Code Of The Provider CA
Country Code Of The Provider US
Provider Type Of The Provider Physician Assistant
Medicare Participation Indicator Y
Number Of HCPCS 3
Number Of Services 246
Number Of Medicare Beneficiaries 169
Total Submitted Charge Amount 56890
Total Medicare Allowed Amount 31724.17
Total Medicare Payment Amount 23164.67
Total Medicare Standardized Payment Amount 24637.37
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 246
Number Of Medicare Beneficiaries With Medical Services 169
Total Medical Submitted Charge Amount 56890
Total Medical Medicare Allowed Amount 31724.17
Total Medical Medicare Payment Amount 23164.67
Total Medical Medicare Standardized Payment Amount 24637.37
Average Age Of Beneficiaries 70
Number Of Beneficiaries Age Less65 27
Number Of Beneficiaries Age 65 to 74 98
Number Of Beneficiaries Age 75 to 84 33
Number Of Beneficiaries Age Greater 84 11
Number Of Female Beneficiaries 120
Number Of Male Beneficiaries 49
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
Number Of Beneficiaries With Medicare Medicaid Entitlement
Percent Of With Atrial Fibrillation 9
Percent Of With Alzheimers Disease or Dementia 9
Percent Of With Asthma 9
Percent Of With Cancer 9
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease 12
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 30
Percent Of With Diabetes 24
Percent Of With Hyperlipidemia 53
Percent Of With Hypertension 46
Percent Of With Ischemic Heart Disease 21
Percent Of With Osteoporosis 11
Percent Of With Rheumatoid Arthritis Osteoarthritis 50
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 1.0286

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