National Provider Identifier [NPI]: |
1568464162 |
Last Name Of The Provider |
FRY |
First Name Of The Provider |
CHRISTY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
423 N 21ST ST |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
CAMP HILL |
Zip Code Of The Provider |
170112207 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
173 |
Number Of Medicare Beneficiaries |
121 |
Total Submitted Charge Amount |
22335 |
Total Medicare Allowed Amount |
15116.66 |
Total Medicare Payment Amount |
9640.83 |
Total Medicare Standardized Payment Amount |
12332.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
173 |
Number Of Medicare Beneficiaries With Medical Services |
121 |
Total Medical Submitted Charge Amount |
22335 |
Total Medical Medicare Allowed Amount |
15116.66 |
Total Medical Medicare Payment Amount |
9640.83 |
Total Medical Medicare Standardized Payment Amount |
12332.37 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
72 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
107 |
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 |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6683 |