National Provider Identifier [NPI]: |
1437582137 |
Last Name Of The Provider |
SOTO |
First Name Of The Provider |
VERONICA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
AA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5424 GRAND BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW PORT RICHEY |
Zip Code Of The Provider |
346524008 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiologist Assistants |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
278 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
339622.5 |
Total Medicare Allowed Amount |
75227.04 |
Total Medicare Payment Amount |
58528.42 |
Total Medicare Standardized Payment Amount |
56781.58 |
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 |
50 |
Number Of Medical Services |
278 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
339622.5 |
Total Medical Medicare Allowed Amount |
75227.04 |
Total Medical Medicare Payment Amount |
58528.42 |
Total Medical Medicare Standardized Payment Amount |
56781.58 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
160 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
247 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
206 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0875 |