National Provider Identifier [NPI]: |
1629315114 |
Last Name Of The Provider |
BILTZ |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
NP-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1303 E HERNDON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937203309 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
203 |
Number Of Medicare Beneficiaries |
175 |
Total Submitted Charge Amount |
65872 |
Total Medicare Allowed Amount |
15545.91 |
Total Medicare Payment Amount |
11368.66 |
Total Medicare Standardized Payment Amount |
13393.82 |
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 |
27 |
Number Of Medical Services |
203 |
Number Of Medicare Beneficiaries With Medical Services |
175 |
Total Medical Submitted Charge Amount |
65872 |
Total Medical Medicare Allowed Amount |
15545.91 |
Total Medical Medicare Payment Amount |
11368.66 |
Total Medical Medicare Standardized Payment Amount |
13393.82 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
83 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
60 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4014 |