National Provider Identifier [NPI]: |
1669434262 |
Last Name Of The Provider |
GREEN |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
120 E BEAUREGARD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANGELO |
Zip Code Of The Provider |
769035919 |
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 |
115 |
Number Of Services |
2310 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
70053.54 |
Total Medicare Allowed Amount |
58416.12 |
Total Medicare Payment Amount |
45006.27 |
Total Medicare Standardized Payment Amount |
53446.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
119 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
1112.39 |
Total Drug Medicare AllowedAmount |
993.7 |
Total Drug Medicare PaymentAmount |
930.9 |
Total Drug Medicare Standardized Payment Amount |
930.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
108 |
Number Of Medical Services |
2191 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
68941.15 |
Total Medical Medicare Allowed Amount |
57422.42 |
Total Medical Medicare Payment Amount |
44075.37 |
Total Medical Medicare Standardized Payment Amount |
52515.24 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
133 |
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 |
124 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.185 |