National Provider Identifier [NPI]: |
1417285784 |
Last Name Of The Provider |
FERNANDEZ |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
130 HOSPITAL RD |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
PRINCE FREDERICK |
Zip Code Of The Provider |
206784015 |
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 |
15 |
Number Of Services |
1202 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
189825.52 |
Total Medicare Allowed Amount |
77870.57 |
Total Medicare Payment Amount |
53811.74 |
Total Medicare Standardized Payment Amount |
64378.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
119 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
1476.22 |
Total Drug Medicare AllowedAmount |
353.27 |
Total Drug Medicare PaymentAmount |
274.18 |
Total Drug Medicare Standardized Payment Amount |
274.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
1083 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
188349.3 |
Total Medical Medicare Allowed Amount |
77517.3 |
Total Medical Medicare Payment Amount |
53537.56 |
Total Medical Medicare Standardized Payment Amount |
64104.46 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
225 |
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 |
188 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3186 |