National Provider Identifier [NPI]: |
1710258462 |
Last Name Of The Provider |
TRAN |
First Name Of The Provider |
VANGIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
26891 ALISO CREEK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALISO VIEJO |
Zip Code Of The Provider |
926563392 |
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 |
18 |
Number Of Services |
81 |
Number Of Medicare Beneficiaries |
42 |
Total Submitted Charge Amount |
3738.8 |
Total Medicare Allowed Amount |
3208.5 |
Total Medicare Payment Amount |
2023.01 |
Total Medicare Standardized Payment Amount |
2426.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
1051.8 |
Total Drug Medicare AllowedAmount |
814.68 |
Total Drug Medicare PaymentAmount |
795.84 |
Total Drug Medicare Standardized Payment Amount |
795.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
56 |
Number Of Medicare Beneficiaries With Medical Services |
42 |
Total Medical Submitted Charge Amount |
2687 |
Total Medical Medicare Allowed Amount |
2393.82 |
Total Medical Medicare Payment Amount |
1227.17 |
Total Medical Medicare Standardized Payment Amount |
1630.34 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
28 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
28 |
Number Of Male Beneficiaries |
14 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
31 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.6347 |