National Provider Identifier [NPI]: |
1205147733 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
ADRIANA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1746 W GOODWIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PLEASANTON |
Zip Code Of The Provider |
780644500 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
1892 |
Number Of Medicare Beneficiaries |
326 |
Total Submitted Charge Amount |
118402 |
Total Medicare Allowed Amount |
75989.62 |
Total Medicare Payment Amount |
57406.09 |
Total Medicare Standardized Payment Amount |
70561.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
728 |
Number Of Medicare Beneficiaries With Drug Services |
117 |
Total Drug Submitted ChargeAmount |
4334 |
Total Drug Medicare AllowedAmount |
1519.9 |
Total Drug Medicare PaymentAmount |
1390.44 |
Total Drug Medicare Standardized Payment Amount |
1390.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1164 |
Number Of Medicare Beneficiaries With Medical Services |
326 |
Total Medical Submitted Charge Amount |
114068 |
Total Medical Medicare Allowed Amount |
74469.72 |
Total Medical Medicare Payment Amount |
56015.65 |
Total Medical Medicare Standardized Payment Amount |
69171.26 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
209 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
235 |
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4496 |