National Provider Identifier [NPI]: |
1437178530 |
Last Name Of The Provider |
SANTANA |
First Name Of The Provider |
MARIA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1207 FAIRCHILD CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
WOODLAND |
Zip Code Of The Provider |
956954321 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
201 |
Number Of Medicare Beneficiaries |
108 |
Total Submitted Charge Amount |
46696 |
Total Medicare Allowed Amount |
12671.96 |
Total Medicare Payment Amount |
8197.85 |
Total Medicare Standardized Payment Amount |
9794.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
776 |
Total Drug Medicare AllowedAmount |
157.86 |
Total Drug Medicare PaymentAmount |
151.67 |
Total Drug Medicare Standardized Payment Amount |
151.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
181 |
Number Of Medicare Beneficiaries With Medical Services |
108 |
Total Medical Submitted Charge Amount |
45920 |
Total Medical Medicare Allowed Amount |
12514.1 |
Total Medical Medicare Payment Amount |
8046.18 |
Total Medical Medicare Standardized Payment Amount |
9643.09 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
59 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
39 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
40 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2185 |