National Provider Identifier [NPI]: |
1205860913 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
VINCENT |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
APN, CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
173 MIDDLE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANCASTER |
Zip Code Of The Provider |
035843508 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
262 |
Number Of Medicare Beneficiaries |
256 |
Total Submitted Charge Amount |
150536.4 |
Total Medicare Allowed Amount |
29688.65 |
Total Medicare Payment Amount |
23060.15 |
Total Medicare Standardized Payment Amount |
23137.67 |
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 |
54 |
Number Of Medical Services |
262 |
Number Of Medicare Beneficiaries With Medical Services |
256 |
Total Medical Submitted Charge Amount |
150536.4 |
Total Medical Medicare Allowed Amount |
29688.65 |
Total Medical Medicare Payment Amount |
23060.15 |
Total Medical Medicare Standardized Payment Amount |
23137.67 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
139 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
230 |
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 |
169 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
87 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3723 |