National Provider Identifier [NPI]: |
1972512473 |
Last Name Of The Provider |
NUNN |
First Name Of The Provider |
STUART |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
420 W ROWLAND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COVINA |
Zip Code Of The Provider |
917232943 |
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 |
47 |
Number Of Services |
548 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
53119 |
Total Medicare Allowed Amount |
26517.39 |
Total Medicare Payment Amount |
18450.96 |
Total Medicare Standardized Payment Amount |
20588.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
93 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
2550 |
Total Drug Medicare AllowedAmount |
728.41 |
Total Drug Medicare PaymentAmount |
100.98 |
Total Drug Medicare Standardized Payment Amount |
100.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
455 |
Number Of Medicare Beneficiaries With Medical Services |
142 |
Total Medical Submitted Charge Amount |
50569 |
Total Medical Medicare Allowed Amount |
25788.98 |
Total Medical Medicare Payment Amount |
18349.98 |
Total Medical Medicare Standardized Payment Amount |
20488.01 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
91 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0312 |