National Provider Identifier [NPI]: |
1346527462 |
Last Name Of The Provider |
OLSEN |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11333 SEPULVEDA BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MISSION HILLS |
Zip Code Of The Provider |
913451116 |
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 |
47 |
Number Of Services |
234 |
Number Of Medicare Beneficiaries |
76 |
Total Submitted Charge Amount |
16955 |
Total Medicare Allowed Amount |
7719.67 |
Total Medicare Payment Amount |
5644.57 |
Total Medicare Standardized Payment Amount |
6079.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
65 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
710 |
Total Drug Medicare AllowedAmount |
51.72 |
Total Drug Medicare PaymentAmount |
37.51 |
Total Drug Medicare Standardized Payment Amount |
37.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
169 |
Number Of Medicare Beneficiaries With Medical Services |
76 |
Total Medical Submitted Charge Amount |
16245 |
Total Medical Medicare Allowed Amount |
7667.95 |
Total Medical Medicare Payment Amount |
5607.06 |
Total Medical Medicare Standardized Payment Amount |
6041.66 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
62 |
Number Of Black or African American Beneficiaries |
|
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 |
54 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
22 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0206 |