National Provider Identifier [NPI]: |
1518268549 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
BROOKE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 KAHELU AVE |
Street Address 2 Of The Provider |
SUITE 226 |
City Of The Provider |
MILILANI |
Zip Code Of The Provider |
967893913 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1164 |
Number Of Medicare Beneficiaries |
150 |
Total Submitted Charge Amount |
234932.85 |
Total Medicare Allowed Amount |
63983.36 |
Total Medicare Payment Amount |
46820.54 |
Total Medicare Standardized Payment Amount |
52344.08 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
72 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
77 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
35 |
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
|
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.829 |