National Provider Identifier [NPI]: |
1316100696 |
Last Name Of The Provider |
SAZAMA |
First Name Of The Provider |
MICHELE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2946 E BANNER GATEWAY DR. |
Street Address 2 Of The Provider |
|
City Of The Provider |
GILBERT |
Zip Code Of The Provider |
85234 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
531 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
81000 |
Total Medicare Allowed Amount |
39720.6 |
Total Medicare Payment Amount |
28720.95 |
Total Medicare Standardized Payment Amount |
35508.87 |
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 |
10 |
Number Of Medical Services |
531 |
Number Of Medicare Beneficiaries With Medical Services |
291 |
Total Medical Submitted Charge Amount |
81000 |
Total Medical Medicare Allowed Amount |
39720.6 |
Total Medical Medicare Payment Amount |
28720.95 |
Total Medical Medicare Standardized Payment Amount |
35508.87 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
231 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
262 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
277 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.9124 |