National Provider Identifier [NPI]: |
1437192127 |
Last Name Of The Provider |
BOGGS |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
906 N US 421 HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLINTON |
Zip Code Of The Provider |
283280410 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
56 |
Number Of Medicare Beneficiaries |
33 |
Total Submitted Charge Amount |
2899.36 |
Total Medicare Allowed Amount |
1377.09 |
Total Medicare Payment Amount |
1047.58 |
Total Medicare Standardized Payment Amount |
1165.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
49.11 |
Total Drug Medicare AllowedAmount |
20.12 |
Total Drug Medicare PaymentAmount |
12.64 |
Total Drug Medicare Standardized Payment Amount |
12.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
40 |
Number Of Medicare Beneficiaries With Medical Services |
28 |
Total Medical Submitted Charge Amount |
2850.25 |
Total Medical Medicare Allowed Amount |
1356.97 |
Total Medical Medicare Payment Amount |
1034.94 |
Total Medical Medicare Standardized Payment Amount |
1152.84 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
15 |
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 |
15 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
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 |
48 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2126 |