National Provider Identifier [NPI]: |
1215205828 |
Last Name Of The Provider |
LAWRENCE |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7705 POPLAR AVE STE 310B |
Street Address 2 Of The Provider |
|
City Of The Provider |
GERMANTOWN |
Zip Code Of The Provider |
381383930 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
105 |
Number Of Medicare Beneficiaries |
42 |
Total Submitted Charge Amount |
5723 |
Total Medicare Allowed Amount |
2702.68 |
Total Medicare Payment Amount |
2051.53 |
Total Medicare Standardized Payment Amount |
2051.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
51 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
345 |
Total Drug Medicare AllowedAmount |
86.12 |
Total Drug Medicare PaymentAmount |
69.04 |
Total Drug Medicare Standardized Payment Amount |
69.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
54 |
Number Of Medicare Beneficiaries With Medical Services |
41 |
Total Medical Submitted Charge Amount |
5378 |
Total Medical Medicare Allowed Amount |
2616.56 |
Total Medical Medicare Payment Amount |
1982.49 |
Total Medical Medicare Standardized Payment Amount |
1982.49 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
24 |
Number Of Male Beneficiaries |
18 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
36 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9155 |