National Provider Identifier [NPI]: |
1528383858 |
Last Name Of The Provider |
CARSWELL |
First Name Of The Provider |
JOSHUA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
150 RIVER NORTH BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
STEPHENVILLE |
Zip Code Of The Provider |
764011803 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
761 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
42479 |
Total Medicare Allowed Amount |
23237.13 |
Total Medicare Payment Amount |
16543.84 |
Total Medicare Standardized Payment Amount |
19952.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
156 |
Number Of Medicare Beneficiaries With Drug Services |
113 |
Total Drug Submitted ChargeAmount |
5250 |
Total Drug Medicare AllowedAmount |
2456.23 |
Total Drug Medicare PaymentAmount |
2310.16 |
Total Drug Medicare Standardized Payment Amount |
2310.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
605 |
Number Of Medicare Beneficiaries With Medical Services |
235 |
Total Medical Submitted Charge Amount |
37229 |
Total Medical Medicare Allowed Amount |
20780.9 |
Total Medical Medicare Payment Amount |
14233.68 |
Total Medical Medicare Standardized Payment Amount |
17642.58 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
214 |
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 |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9536 |