National Provider Identifier [NPI]: |
1720035652 |
Last Name Of The Provider |
MALKI |
First Name Of The Provider |
TERESA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
215 S ALLISON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
XENIA |
Zip Code Of The Provider |
453853694 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1006 |
Number Of Medicare Beneficiaries |
293 |
Total Submitted Charge Amount |
133149 |
Total Medicare Allowed Amount |
77869.06 |
Total Medicare Payment Amount |
57553.24 |
Total Medicare Standardized Payment Amount |
69796.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
1006 |
Number Of Medicare Beneficiaries With Medical Services |
293 |
Total Medical Submitted Charge Amount |
133149 |
Total Medical Medicare Allowed Amount |
77869.06 |
Total Medical Medicare Payment Amount |
57553.24 |
Total Medical Medicare Standardized Payment Amount |
69796.5 |
Average Age Of Beneficiaries |
85 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
172 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
275 |
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 |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.3291 |