National Provider Identifier [NPI]: |
1932189701 |
Last Name Of The Provider |
JAMIESON |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2025 SOQUEL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA CRUZ |
Zip Code Of The Provider |
950621323 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
1032 |
Number Of Medicare Beneficiaries |
297 |
Total Submitted Charge Amount |
198407.5 |
Total Medicare Allowed Amount |
81587.19 |
Total Medicare Payment Amount |
58039.99 |
Total Medicare Standardized Payment Amount |
55816.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
194 |
Number Of Medicare Beneficiaries With Drug Services |
85 |
Total Drug Submitted ChargeAmount |
9198 |
Total Drug Medicare AllowedAmount |
5586.68 |
Total Drug Medicare PaymentAmount |
5083.2 |
Total Drug Medicare Standardized Payment Amount |
5083.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
838 |
Number Of Medicare Beneficiaries With Medical Services |
297 |
Total Medical Submitted Charge Amount |
189209.5 |
Total Medical Medicare Allowed Amount |
76000.51 |
Total Medical Medicare Payment Amount |
52956.79 |
Total Medical Medicare Standardized Payment Amount |
50733.21 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
243 |
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 |
248 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8846 |