National Provider Identifier [NPI]: |
1831269224 |
Last Name Of The Provider |
HIGH |
First Name Of The Provider |
ALICIA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 E COLLEGE AVE |
Street Address 2 Of The Provider |
DEPARTMENT OF ORTHOPAEDICS |
City Of The Provider |
BLOOMINGTON |
Zip Code Of The Provider |
617042101 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
790 |
Number Of Medicare Beneficiaries |
139 |
Total Submitted Charge Amount |
80340 |
Total Medicare Allowed Amount |
25121.92 |
Total Medicare Payment Amount |
17052.97 |
Total Medicare Standardized Payment Amount |
21482.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
464 |
Number Of Medicare Beneficiaries With Drug Services |
64 |
Total Drug Submitted ChargeAmount |
14464 |
Total Drug Medicare AllowedAmount |
2348.43 |
Total Drug Medicare PaymentAmount |
1811.44 |
Total Drug Medicare Standardized Payment Amount |
1811.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
326 |
Number Of Medicare Beneficiaries With Medical Services |
139 |
Total Medical Submitted Charge Amount |
65876 |
Total Medical Medicare Allowed Amount |
22773.49 |
Total Medical Medicare Payment Amount |
15241.53 |
Total Medical Medicare Standardized Payment Amount |
19671.22 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
40 |
Number Of Non Hispanic White Beneficiaries |
126 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0344 |