National Provider Identifier [NPI]: |
1609826510 |
Last Name Of The Provider |
AN |
First Name Of The Provider |
ANDREA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2201 W FAIRVIEW ST |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
CHANDLER |
Zip Code Of The Provider |
852245668 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
6001 |
Number Of Medicare Beneficiaries |
658 |
Total Submitted Charge Amount |
713940 |
Total Medicare Allowed Amount |
350400.77 |
Total Medicare Payment Amount |
262260.99 |
Total Medicare Standardized Payment Amount |
263738.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
3567 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
42656 |
Total Drug Medicare AllowedAmount |
19550.3 |
Total Drug Medicare PaymentAmount |
15325.05 |
Total Drug Medicare Standardized Payment Amount |
15325.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
2434 |
Number Of Medicare Beneficiaries With Medical Services |
658 |
Total Medical Submitted Charge Amount |
671284 |
Total Medical Medicare Allowed Amount |
330850.47 |
Total Medical Medicare Payment Amount |
246935.94 |
Total Medical Medicare Standardized Payment Amount |
248413.1 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
263 |
Number Of Beneficiaries Age 75 to 84 |
210 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
385 |
Number Of Male Beneficiaries |
273 |
Number Of Non Hispanic White Beneficiaries |
543 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
18 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
555 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
1.6708 |