National Provider Identifier [NPI]: |
1871826990 |
Last Name Of The Provider |
CARTER |
First Name Of The Provider |
PHILIP |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HURRICANE |
Zip Code Of The Provider |
847371949 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
337 |
Number Of Medicare Beneficiaries |
117 |
Total Submitted Charge Amount |
24962 |
Total Medicare Allowed Amount |
12258.95 |
Total Medicare Payment Amount |
6882.68 |
Total Medicare Standardized Payment Amount |
9012.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
86 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
879 |
Total Drug Medicare AllowedAmount |
151.76 |
Total Drug Medicare PaymentAmount |
99.08 |
Total Drug Medicare Standardized Payment Amount |
99.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
251 |
Number Of Medicare Beneficiaries With Medical Services |
117 |
Total Medical Submitted Charge Amount |
24083 |
Total Medical Medicare Allowed Amount |
12107.19 |
Total Medical Medicare Payment Amount |
6783.6 |
Total Medical Medicare Standardized Payment Amount |
8913.13 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
57 |
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 |
88 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
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 |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9811 |