National Provider Identifier [NPI]: |
1780028811 |
Last Name Of The Provider |
ARCAY |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
NP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
620 SHADOW LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891064119 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
111 |
Number Of Medicare Beneficiaries |
106 |
Total Submitted Charge Amount |
106441 |
Total Medicare Allowed Amount |
10287.1 |
Total Medicare Payment Amount |
7660.32 |
Total Medicare Standardized Payment Amount |
8927.65 |
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 |
8 |
Number Of Medical Services |
111 |
Number Of Medicare Beneficiaries With Medical Services |
106 |
Total Medical Submitted Charge Amount |
106441 |
Total Medical Medicare Allowed Amount |
10287.1 |
Total Medical Medicare Payment Amount |
7660.32 |
Total Medical Medicare Standardized Payment Amount |
8927.65 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
68 |
Number Of Black or African American Beneficiaries |
27 |
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 |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
21 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4534 |