National Provider Identifier [NPI]: |
1073622932 |
Last Name Of The Provider |
RASTAD |
First Name Of The Provider |
JANELLE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4430 E RAY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850446092 |
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 |
16 |
Number Of Services |
287 |
Number Of Medicare Beneficiaries |
153 |
Total Submitted Charge Amount |
10940.89 |
Total Medicare Allowed Amount |
10030.85 |
Total Medicare Payment Amount |
8282.86 |
Total Medicare Standardized Payment Amount |
9483.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
111 |
Number Of Medicare Beneficiaries With Drug Services |
104 |
Total Drug Submitted ChargeAmount |
3635.89 |
Total Drug Medicare AllowedAmount |
3576.61 |
Total Drug Medicare PaymentAmount |
3505.06 |
Total Drug Medicare Standardized Payment Amount |
3505.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
176 |
Number Of Medicare Beneficiaries With Medical Services |
153 |
Total Medical Submitted Charge Amount |
7305 |
Total Medical Medicare Allowed Amount |
6454.24 |
Total Medical Medicare Payment Amount |
4777.8 |
Total Medical Medicare Standardized Payment Amount |
5978.43 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
139 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8926 |