National Provider Identifier [NPI]: |
1013905744 |
Last Name Of The Provider |
PEREZ |
First Name Of The Provider |
VICTORIA |
Middle Initial Of The Provider |
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Credentials Of The Provider |
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Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5355 LYONS RD |
Street Address 2 Of The Provider |
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City Of The Provider |
COCONUT CREEK |
Zip Code Of The Provider |
330732825 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
177 |
Number Of Medicare Beneficiaries |
49 |
Total Submitted Charge Amount |
17349 |
Total Medicare Allowed Amount |
9802.4 |
Total Medicare Payment Amount |
6909.86 |
Total Medicare Standardized Payment Amount |
7926.81 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
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Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
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Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
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Number Of Beneficiaries Age 65 to 74 |
22 |
Number Of Beneficiaries Age 75 to 84 |
11 |
Number Of Beneficiaries Age Greater 84 |
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Number Of Female Beneficiaries |
34 |
Number Of Male Beneficiaries |
15 |
Number Of Non Hispanic White Beneficiaries |
27 |
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
27 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
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Percent Of With Alzheimers Disease or Dementia |
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Percent Of With Asthma |
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Percent Of With Cancer |
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Percent Of With Heart Failure |
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Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
0 |
Percent Of With Depression |
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Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
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Percent Of With Osteoporosis |
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Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.4533 |