National Provider Identifier [NPI]: |
1629374814 |
Last Name Of The Provider |
GILBERT |
First Name Of The Provider |
ALIX |
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 |
11110 MEDICAL CAMPUS RD |
Street Address 2 Of The Provider |
SUITE 107 |
City Of The Provider |
HAGERSTOWN |
Zip Code Of The Provider |
217426700 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
474 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
89879 |
Total Medicare Allowed Amount |
30559.39 |
Total Medicare Payment Amount |
23172.67 |
Total Medicare Standardized Payment Amount |
26680.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
2776 |
Total Drug Medicare AllowedAmount |
1741.36 |
Total Drug Medicare PaymentAmount |
1706.02 |
Total Drug Medicare Standardized Payment Amount |
1706.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
443 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
87103 |
Total Medical Medicare Allowed Amount |
28818.03 |
Total Medical Medicare Payment Amount |
21466.65 |
Total Medical Medicare Standardized Payment Amount |
24974.48 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
147 |
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 |
112 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
16 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9954 |