National Provider Identifier [NPI]: |
1487960910 |
Last Name Of The Provider |
TRINIDAD |
First Name Of The Provider |
REYGIL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1633 S COURT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
VISALIA |
Zip Code Of The Provider |
932774945 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
267 |
Number Of Medicare Beneficiaries |
205 |
Total Submitted Charge Amount |
95942 |
Total Medicare Allowed Amount |
23001.41 |
Total Medicare Payment Amount |
17398.33 |
Total Medicare Standardized Payment Amount |
20373.43 |
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 |
17 |
Number Of Medical Services |
267 |
Number Of Medicare Beneficiaries With Medical Services |
205 |
Total Medical Submitted Charge Amount |
95942 |
Total Medical Medicare Allowed Amount |
23001.41 |
Total Medical Medicare Payment Amount |
17398.33 |
Total Medical Medicare Standardized Payment Amount |
20373.43 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
153 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
121 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.533 |