National Provider Identifier [NPI]: |
1609802461 |
Last Name Of The Provider |
BRILLHART |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25 MONUMENT RD |
Street Address 2 Of The Provider |
SUITE 190 |
City Of The Provider |
YORK |
Zip Code Of The Provider |
174035060 |
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 |
26 |
Number Of Services |
229 |
Number Of Medicare Beneficiaries |
100 |
Total Submitted Charge Amount |
51198.6 |
Total Medicare Allowed Amount |
17495.65 |
Total Medicare Payment Amount |
13699.91 |
Total Medicare Standardized Payment Amount |
14288.33 |
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 |
26 |
Number Of Medical Services |
229 |
Number Of Medicare Beneficiaries With Medical Services |
100 |
Total Medical Submitted Charge Amount |
51198.6 |
Total Medical Medicare Allowed Amount |
17495.65 |
Total Medical Medicare Payment Amount |
13699.91 |
Total Medical Medicare Standardized Payment Amount |
14288.33 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
42 |
Number Of Male Beneficiaries |
58 |
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 |
85 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
66 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.522 |