National Provider Identifier [NPI]: |
1801938246 |
Last Name Of The Provider |
AMADOR |
First Name Of The Provider |
VICTORIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
F.N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6410 NE HALSEY ST |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972134759 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
97 |
Number Of Medicare Beneficiaries |
76 |
Total Submitted Charge Amount |
45751 |
Total Medicare Allowed Amount |
12341.54 |
Total Medicare Payment Amount |
9511.46 |
Total Medicare Standardized Payment Amount |
11207.79 |
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 |
18 |
Number Of Medical Services |
97 |
Number Of Medicare Beneficiaries With Medical Services |
76 |
Total Medical Submitted Charge Amount |
45751 |
Total Medical Medicare Allowed Amount |
12341.54 |
Total Medical Medicare Payment Amount |
9511.46 |
Total Medical Medicare Standardized Payment Amount |
11207.79 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
16 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
45 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
50 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
47 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
1.8218 |