National Provider Identifier [NPI]: |
1518912500 |
Last Name Of The Provider |
MIZUNO |
First Name Of The Provider |
PHILIP |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
CFNP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12250 E ILIFF AVE |
Street Address 2 Of The Provider |
#300 |
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800146318 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
4104 |
Number Of Medicare Beneficiaries |
501 |
Total Submitted Charge Amount |
862320 |
Total Medicare Allowed Amount |
336764.64 |
Total Medicare Payment Amount |
255837.63 |
Total Medicare Standardized Payment Amount |
301948.1 |
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 |
15 |
Number Of Medical Services |
4104 |
Number Of Medicare Beneficiaries With Medical Services |
501 |
Total Medical Submitted Charge Amount |
862320 |
Total Medical Medicare Allowed Amount |
336764.64 |
Total Medical Medicare Payment Amount |
255837.63 |
Total Medical Medicare Standardized Payment Amount |
301948.1 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
164 |
Number Of Female Beneficiaries |
271 |
Number Of Male Beneficiaries |
230 |
Number Of Non Hispanic White Beneficiaries |
391 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
59 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
211 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
290 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
62 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.6931 |