National Provider Identifier [NPI]: |
1790989630 |
Last Name Of The Provider |
REX-VITAL |
First Name Of The Provider |
LOQUINTHA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
APRN-BC, BC-ADM, NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2921 SAVIERS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
OXNARD |
Zip Code Of The Provider |
930335314 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
176 |
Number Of Medicare Beneficiaries |
74 |
Total Submitted Charge Amount |
26106 |
Total Medicare Allowed Amount |
11038.87 |
Total Medicare Payment Amount |
7741.38 |
Total Medicare Standardized Payment Amount |
8679.02 |
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 |
7 |
Number Of Medical Services |
176 |
Number Of Medicare Beneficiaries With Medical Services |
74 |
Total Medical Submitted Charge Amount |
26106 |
Total Medical Medicare Allowed Amount |
11038.87 |
Total Medical Medicare Payment Amount |
7741.38 |
Total Medical Medicare Standardized Payment Amount |
8679.02 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
14 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
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 |
19 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
18 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.4378 |