National Provider Identifier [NPI]: |
1467798165 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
DANIELLE |
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 |
231 GRANITE RUN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANCASTER |
Zip Code Of The Provider |
176016823 |
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 |
55 |
Number Of Services |
589 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
188267 |
Total Medicare Allowed Amount |
34490.87 |
Total Medicare Payment Amount |
27385.71 |
Total Medicare Standardized Payment Amount |
30502.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
32 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
702 |
Total Drug Medicare AllowedAmount |
160.06 |
Total Drug Medicare PaymentAmount |
125.44 |
Total Drug Medicare Standardized Payment Amount |
125.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
557 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
187565 |
Total Medical Medicare Allowed Amount |
34330.81 |
Total Medical Medicare Payment Amount |
27260.27 |
Total Medical Medicare Standardized Payment Amount |
30376.85 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
74 |
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 |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.37 |