National Provider Identifier [NPI]: |
1952736548 |
Last Name Of The Provider |
AQUINO |
First Name Of The Provider |
ELENA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12280 LAKE UNDERHILL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORLANDO |
Zip Code Of The Provider |
32825 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
164 |
Number Of Medicare Beneficiaries |
93 |
Total Submitted Charge Amount |
7148.49 |
Total Medicare Allowed Amount |
6510.2 |
Total Medicare Payment Amount |
4522.87 |
Total Medicare Standardized Payment Amount |
5338.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
1638.49 |
Total Drug Medicare AllowedAmount |
1588.8 |
Total Drug Medicare PaymentAmount |
1536.72 |
Total Drug Medicare Standardized Payment Amount |
1536.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
110 |
Number Of Medicare Beneficiaries With Medical Services |
93 |
Total Medical Submitted Charge Amount |
5510 |
Total Medical Medicare Allowed Amount |
4921.4 |
Total Medical Medicare Payment Amount |
2986.15 |
Total Medical Medicare Standardized Payment Amount |
3801.78 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
45 |
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 |
81 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
13 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8478 |