National Provider Identifier [NPI]: |
1366771321 |
Last Name Of The Provider |
DANIEL |
First Name Of The Provider |
MELINDA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
AHCNS |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1108 LAVACA ST |
Street Address 2 Of The Provider |
SUITE 110-320 |
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787012172 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Certified Clinical Nurse Specialist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
1419 |
Number Of Medicare Beneficiaries |
466 |
Total Submitted Charge Amount |
152355 |
Total Medicare Allowed Amount |
87609.97 |
Total Medicare Payment Amount |
65361.09 |
Total Medicare Standardized Payment Amount |
80354.45 |
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 |
6 |
Number Of Medical Services |
1419 |
Number Of Medicare Beneficiaries With Medical Services |
466 |
Total Medical Submitted Charge Amount |
152355 |
Total Medical Medicare Allowed Amount |
87609.97 |
Total Medical Medicare Payment Amount |
65361.09 |
Total Medical Medicare Standardized Payment Amount |
80354.45 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
226 |
Number Of Female Beneficiaries |
323 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
394 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
267 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
74 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
65 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3435 |