National Provider Identifier [NPI]: |
1669474243 |
Last Name Of The Provider |
TORONTO |
First Name Of The Provider |
COLETTE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6565 E GREENWAY PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
852542073 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
398 |
Number Of Medicare Beneficiaries |
173 |
Total Submitted Charge Amount |
64046 |
Total Medicare Allowed Amount |
22083.93 |
Total Medicare Payment Amount |
14474.94 |
Total Medicare Standardized Payment Amount |
17793.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
2775 |
Total Drug Medicare AllowedAmount |
1228.78 |
Total Drug Medicare PaymentAmount |
1204.1 |
Total Drug Medicare Standardized Payment Amount |
1204.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
372 |
Number Of Medicare Beneficiaries With Medical Services |
173 |
Total Medical Submitted Charge Amount |
61271 |
Total Medical Medicare Allowed Amount |
20855.15 |
Total Medical Medicare Payment Amount |
13270.84 |
Total Medical Medicare Standardized Payment Amount |
16589.76 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
162 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9475 |