National Provider Identifier [NPI]: |
1962663773 |
Last Name Of The Provider |
ABILMONA |
First Name Of The Provider |
FAUZIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11315 BRIDGEPORT WAY SW |
Street Address 2 Of The Provider |
FRANCISCAN ANESTHESIA ASSOCIATES |
City Of The Provider |
LAKEWOOD |
Zip Code Of The Provider |
984993004 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
236 |
Number Of Medicare Beneficiaries |
184 |
Total Submitted Charge Amount |
234680 |
Total Medicare Allowed Amount |
48750.91 |
Total Medicare Payment Amount |
38051.07 |
Total Medicare Standardized Payment Amount |
39064.14 |
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 |
38 |
Number Of Medical Services |
236 |
Number Of Medicare Beneficiaries With Medical Services |
184 |
Total Medical Submitted Charge Amount |
234680 |
Total Medical Medicare Allowed Amount |
48750.91 |
Total Medical Medicare Payment Amount |
38051.07 |
Total Medical Medicare Standardized Payment Amount |
39064.14 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
161 |
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 |
152 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1161 |