National Provider Identifier [NPI]: |
1225176191 |
Last Name Of The Provider |
ARMITAGE |
First Name Of The Provider |
DAMON |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
208 W CASABLANCA AVE |
Street Address 2 Of The Provider |
BUILDING 1400, 27 SOMDG |
City Of The Provider |
CANNON AFB |
Zip Code Of The Provider |
881035009 |
State Code Of The Provider |
NM |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
1379 |
Number Of Medicare Beneficiaries |
61 |
Total Submitted Charge Amount |
102958 |
Total Medicare Allowed Amount |
46282.09 |
Total Medicare Payment Amount |
32524.42 |
Total Medicare Standardized Payment Amount |
34601.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
553 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
2064 |
Total Drug Medicare AllowedAmount |
1051.51 |
Total Drug Medicare PaymentAmount |
829.33 |
Total Drug Medicare Standardized Payment Amount |
829.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
826 |
Number Of Medicare Beneficiaries With Medical Services |
61 |
Total Medical Submitted Charge Amount |
100894 |
Total Medical Medicare Allowed Amount |
45230.58 |
Total Medical Medicare Payment Amount |
31695.09 |
Total Medical Medicare Standardized Payment Amount |
33772.35 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
33 |
Number Of Male Beneficiaries |
28 |
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 |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7974 |