National Provider Identifier [NPI]: |
1255367587 |
Last Name Of The Provider |
JIMENEZ |
First Name Of The Provider |
ALINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
86 NEW BRUNSWICK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PERTH AMBOY |
Zip Code Of The Provider |
088612242 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
640 |
Number Of Medicare Beneficiaries |
136 |
Total Submitted Charge Amount |
86185 |
Total Medicare Allowed Amount |
35732.97 |
Total Medicare Payment Amount |
27126.23 |
Total Medicare Standardized Payment Amount |
28565.17 |
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 |
7 |
Number Of Medical Services |
640 |
Number Of Medicare Beneficiaries With Medical Services |
136 |
Total Medical Submitted Charge Amount |
86185 |
Total Medical Medicare Allowed Amount |
35732.97 |
Total Medical Medicare Payment Amount |
27126.23 |
Total Medical Medicare Standardized Payment Amount |
28565.17 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
69 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
64 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
41 |
Percent Of With Alzheimers Disease or Dementia |
48 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
2.7889 |