National Provider Identifier [NPI]: |
1043595713 |
Last Name Of The Provider |
ZAJECHOWSKI |
First Name Of The Provider |
KATIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
681 4TH AVE N |
Street Address 2 Of The Provider |
LUGERT WEST BUILDING |
City Of The Provider |
NAPLES |
Zip Code Of The Provider |
341025729 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
892 |
Number Of Medicare Beneficiaries |
401 |
Total Submitted Charge Amount |
173068 |
Total Medicare Allowed Amount |
64595.02 |
Total Medicare Payment Amount |
50392.48 |
Total Medicare Standardized Payment Amount |
56870.25 |
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 |
9 |
Number Of Medical Services |
892 |
Number Of Medicare Beneficiaries With Medical Services |
401 |
Total Medical Submitted Charge Amount |
173068 |
Total Medical Medicare Allowed Amount |
64595.02 |
Total Medical Medicare Payment Amount |
50392.48 |
Total Medical Medicare Standardized Payment Amount |
56870.25 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
362 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
358 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
46 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.5913 |