National Provider Identifier [NPI]: |
1235198417 |
Last Name Of The Provider |
HERNDON |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
PA C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
927 FRANKLIN ST SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HUNTSVILLE |
Zip Code Of The Provider |
358014306 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
1984 |
Number Of Medicare Beneficiaries |
233 |
Total Submitted Charge Amount |
823941 |
Total Medicare Allowed Amount |
49187.03 |
Total Medicare Payment Amount |
36927.12 |
Total Medicare Standardized Payment Amount |
42659.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
1444 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
35404 |
Total Drug Medicare AllowedAmount |
11236.58 |
Total Drug Medicare PaymentAmount |
8806.34 |
Total Drug Medicare Standardized Payment Amount |
8806.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
60 |
Number Of Medical Services |
540 |
Number Of Medicare Beneficiaries With Medical Services |
233 |
Total Medical Submitted Charge Amount |
788537 |
Total Medical Medicare Allowed Amount |
37950.45 |
Total Medical Medicare Payment Amount |
28120.78 |
Total Medical Medicare Standardized Payment Amount |
33853.44 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
153 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
215 |
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 |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9117 |