National Provider Identifier [NPI]: |
1427082833 |
Last Name Of The Provider |
ESTRADA |
First Name Of The Provider |
SANDRA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11370 ANDERSON ST |
Street Address 2 Of The Provider |
SUITE 2400 |
City Of The Provider |
LOMA LINDA |
Zip Code Of The Provider |
923543450 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
13487 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
400600 |
Total Medicare Allowed Amount |
113501.68 |
Total Medicare Payment Amount |
84920.6 |
Total Medicare Standardized Payment Amount |
89888.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
13007 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
260095 |
Total Drug Medicare AllowedAmount |
71343.22 |
Total Drug Medicare PaymentAmount |
55905.74 |
Total Drug Medicare Standardized Payment Amount |
55905.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
480 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
140505 |
Total Medical Medicare Allowed Amount |
42158.46 |
Total Medical Medicare Payment Amount |
29014.86 |
Total Medical Medicare Standardized Payment Amount |
33982.69 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
130 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
106 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
56 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
60 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4474 |