National Provider Identifier [NPI]: |
1659392249 |
Last Name Of The Provider |
HENDRIX |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2225 US HIGHWAY 41 N |
Street Address 2 Of The Provider |
|
City Of The Provider |
TIFTON |
Zip Code Of The Provider |
317942749 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
141 |
Number Of Medicare Beneficiaries |
36 |
Total Submitted Charge Amount |
8542 |
Total Medicare Allowed Amount |
4159.95 |
Total Medicare Payment Amount |
3371.05 |
Total Medicare Standardized Payment Amount |
4077.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
58 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
865 |
Total Drug Medicare AllowedAmount |
147.47 |
Total Drug Medicare PaymentAmount |
134.23 |
Total Drug Medicare Standardized Payment Amount |
134.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
83 |
Number Of Medicare Beneficiaries With Medical Services |
36 |
Total Medical Submitted Charge Amount |
7677 |
Total Medical Medicare Allowed Amount |
4012.48 |
Total Medical Medicare Payment Amount |
3236.82 |
Total Medical Medicare Standardized Payment Amount |
3943.33 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
15 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
23 |
Number Of Male Beneficiaries |
13 |
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1437 |