National Provider Identifier [NPI]: |
1841591484 |
Last Name Of The Provider |
VASQUEZ |
First Name Of The Provider |
PHILIPPE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MPAS, PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2288 AUBURN BLVD |
Street Address 2 Of The Provider |
SUTIE 106 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958211618 |
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 |
25 |
Number Of Services |
1759 |
Number Of Medicare Beneficiaries |
224 |
Total Submitted Charge Amount |
217302.95 |
Total Medicare Allowed Amount |
96836.74 |
Total Medicare Payment Amount |
72992.51 |
Total Medicare Standardized Payment Amount |
83093.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
516 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
5099.7 |
Total Drug Medicare AllowedAmount |
3031 |
Total Drug Medicare PaymentAmount |
2376.32 |
Total Drug Medicare Standardized Payment Amount |
2376.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
1243 |
Number Of Medicare Beneficiaries With Medical Services |
224 |
Total Medical Submitted Charge Amount |
212203.25 |
Total Medical Medicare Allowed Amount |
93805.74 |
Total Medical Medicare Payment Amount |
70616.19 |
Total Medical Medicare Standardized Payment Amount |
80717.31 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
180 |
Number Of Black or African American Beneficiaries |
18 |
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 |
137 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
87 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3795 |