National Provider Identifier [NPI]: |
1528086782 |
Last Name Of The Provider |
PEREZ |
First Name Of The Provider |
VERONICA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1201 ALHAMBRA BLVD |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958165238 |
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 |
29 |
Number Of Services |
479 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
91806 |
Total Medicare Allowed Amount |
25895.97 |
Total Medicare Payment Amount |
17272.56 |
Total Medicare Standardized Payment Amount |
19896.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
109 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
1573 |
Total Drug Medicare AllowedAmount |
149.24 |
Total Drug Medicare PaymentAmount |
125.53 |
Total Drug Medicare Standardized Payment Amount |
125.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
370 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
90233 |
Total Medical Medicare Allowed Amount |
25746.73 |
Total Medical Medicare Payment Amount |
17147.03 |
Total Medical Medicare Standardized Payment Amount |
19771.08 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
60 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
73 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
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 |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0276 |