National Provider Identifier [NPI]: |
1487924965 |
Last Name Of The Provider |
TANZELLA |
First Name Of The Provider |
TONI |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
840 E MCKELLIPS RD |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
MESA |
Zip Code Of The Provider |
852039645 |
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 |
28 |
Number Of Services |
589 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
50265.99 |
Total Medicare Allowed Amount |
32227.46 |
Total Medicare Payment Amount |
19651.73 |
Total Medicare Standardized Payment Amount |
24486.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
106 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
1174 |
Total Drug Medicare AllowedAmount |
667.12 |
Total Drug Medicare PaymentAmount |
602.52 |
Total Drug Medicare Standardized Payment Amount |
602.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
483 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
49091.99 |
Total Medical Medicare Allowed Amount |
31560.34 |
Total Medical Medicare Payment Amount |
19049.21 |
Total Medical Medicare Standardized Payment Amount |
23883.92 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
179 |
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 |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1217 |