National Provider Identifier [NPI]: |
1235110875 |
Last Name Of The Provider |
LAWRENCE |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
390 S MAIN ST |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
ROCKY MOUNT |
Zip Code Of The Provider |
241511766 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
686 |
Number Of Medicare Beneficiaries |
260 |
Total Submitted Charge Amount |
48354 |
Total Medicare Allowed Amount |
31003.57 |
Total Medicare Payment Amount |
18690.54 |
Total Medicare Standardized Payment Amount |
23709.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
69 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
1571 |
Total Drug Medicare AllowedAmount |
903.65 |
Total Drug Medicare PaymentAmount |
863.15 |
Total Drug Medicare Standardized Payment Amount |
863.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
617 |
Number Of Medicare Beneficiaries With Medical Services |
260 |
Total Medical Submitted Charge Amount |
46783 |
Total Medical Medicare Allowed Amount |
30099.92 |
Total Medical Medicare Payment Amount |
17827.39 |
Total Medical Medicare Standardized Payment Amount |
22846.38 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
158 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
223 |
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 |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9254 |