National Provider Identifier [NPI]: |
1477705234 |
Last Name Of The Provider |
EVANS |
First Name Of The Provider |
LACINDA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
R.N |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7703 FLOYD CURL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782293901 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
101 |
Number Of Medicare Beneficiaries |
64 |
Total Submitted Charge Amount |
13114 |
Total Medicare Allowed Amount |
5587.79 |
Total Medicare Payment Amount |
4306.02 |
Total Medicare Standardized Payment Amount |
5246.8 |
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 |
7 |
Number Of Medical Services |
101 |
Number Of Medicare Beneficiaries With Medical Services |
64 |
Total Medical Submitted Charge Amount |
13114 |
Total Medical Medicare Allowed Amount |
5587.79 |
Total Medical Medicare Payment Amount |
4306.02 |
Total Medical Medicare Standardized Payment Amount |
5246.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
14 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
31 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
35 |
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 |
43 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
44 |
Average HCC Risk Score Of Beneficiaries |
1.7763 |