National Provider Identifier [NPI]: |
1164728135 |
Last Name Of The Provider |
FOX |
First Name Of The Provider |
BRITTANY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8420 W WARM SPRINGS RD # 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891133624 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
3574 |
Number Of Medicare Beneficiaries |
266 |
Total Submitted Charge Amount |
881068.12 |
Total Medicare Allowed Amount |
115334.14 |
Total Medicare Payment Amount |
85924.33 |
Total Medicare Standardized Payment Amount |
94359.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
2282 |
Number Of Medicare Beneficiaries With Drug Services |
116 |
Total Drug Submitted ChargeAmount |
72470.12 |
Total Drug Medicare AllowedAmount |
28348.82 |
Total Drug Medicare PaymentAmount |
22215.72 |
Total Drug Medicare Standardized Payment Amount |
22215.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
1292 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
808598 |
Total Medical Medicare Allowed Amount |
86985.32 |
Total Medical Medicare Payment Amount |
63708.61 |
Total Medical Medicare Standardized Payment Amount |
72144.12 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
205 |
Number Of Black or African American Beneficiaries |
31 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
220 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9956 |