National Provider Identifier [NPI]: |
1467513168 |
Last Name Of The Provider |
FUNTANILLA |
First Name Of The Provider |
JOSELYN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1301 PUNCHBOWL ST |
Street Address 2 Of The Provider |
HOSPITALIST PROGRAM |
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968132402 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
451 |
Number Of Medicare Beneficiaries |
174 |
Total Submitted Charge Amount |
63008 |
Total Medicare Allowed Amount |
23339.97 |
Total Medicare Payment Amount |
18114.63 |
Total Medicare Standardized Payment Amount |
20430.29 |
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 |
11 |
Number Of Medical Services |
451 |
Number Of Medicare Beneficiaries With Medical Services |
174 |
Total Medical Submitted Charge Amount |
63008 |
Total Medical Medicare Allowed Amount |
23339.97 |
Total Medical Medicare Payment Amount |
18114.63 |
Total Medical Medicare Standardized Payment Amount |
20430.29 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
43 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
102 |
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 |
142 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1743 |