National Provider Identifier [NPI]: |
1598819674 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
ARNOLD |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
305 W GAY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRANKLIN |
Zip Code Of The Provider |
778564871 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
904 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
101490 |
Total Medicare Allowed Amount |
29292.55 |
Total Medicare Payment Amount |
18457.43 |
Total Medicare Standardized Payment Amount |
24859.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
193 |
Number Of Medicare Beneficiaries With Drug Services |
66 |
Total Drug Submitted ChargeAmount |
7779 |
Total Drug Medicare AllowedAmount |
797.29 |
Total Drug Medicare PaymentAmount |
688.26 |
Total Drug Medicare Standardized Payment Amount |
688.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
711 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
93711 |
Total Medical Medicare Allowed Amount |
28495.26 |
Total Medical Medicare Payment Amount |
17769.17 |
Total Medical Medicare Standardized Payment Amount |
24171.11 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
160 |
Number Of Black or African American Beneficiaries |
16 |
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 |
164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0004 |