National Provider Identifier [NPI]: |
1649211343 |
Last Name Of The Provider |
RIEKERS |
First Name Of The Provider |
WENDY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2625 N CRAYCROFT RD |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857122268 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
572 |
Number Of Medicare Beneficiaries |
254 |
Total Submitted Charge Amount |
284893 |
Total Medicare Allowed Amount |
63832.41 |
Total Medicare Payment Amount |
48376.6 |
Total Medicare Standardized Payment Amount |
49656.23 |
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 |
572 |
Number Of Medicare Beneficiaries With Medical Services |
254 |
Total Medical Submitted Charge Amount |
284893 |
Total Medical Medicare Allowed Amount |
63832.41 |
Total Medical Medicare Payment Amount |
48376.6 |
Total Medical Medicare Standardized Payment Amount |
49656.23 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
232 |
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 |
235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9207 |