National Provider Identifier [NPI]: |
1205167822 |
Last Name Of The Provider |
ACOSTA-TECSON |
First Name Of The Provider |
TRINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
318 W EL NORTE PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
ESCONDIDO |
Zip Code Of The Provider |
920261925 |
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 |
24 |
Number Of Services |
338 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
14624.95 |
Total Medicare Allowed Amount |
12959.46 |
Total Medicare Payment Amount |
9369.56 |
Total Medicare Standardized Payment Amount |
10733.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
107 |
Number Of Medicare Beneficiaries With Drug Services |
99 |
Total Drug Submitted ChargeAmount |
3324.95 |
Total Drug Medicare AllowedAmount |
3265.67 |
Total Drug Medicare PaymentAmount |
3111.76 |
Total Drug Medicare Standardized Payment Amount |
3111.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
231 |
Number Of Medicare Beneficiaries With Medical Services |
190 |
Total Medical Submitted Charge Amount |
11300 |
Total Medical Medicare Allowed Amount |
9693.79 |
Total Medical Medicare Payment Amount |
6257.8 |
Total Medical Medicare Standardized Payment Amount |
7621.6 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
177 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8239 |