National Provider Identifier [NPI]: |
1447689732 |
Last Name Of The Provider |
HOMAN |
First Name Of The Provider |
TRAVIS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
231 GRANITE RUN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANCASTER |
Zip Code Of The Provider |
176016823 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
458 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
290327.25 |
Total Medicare Allowed Amount |
37436.12 |
Total Medicare Payment Amount |
29552.32 |
Total Medicare Standardized Payment Amount |
30260.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
158 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1984 |
Total Drug Medicare AllowedAmount |
1434.33 |
Total Drug Medicare PaymentAmount |
1124.44 |
Total Drug Medicare Standardized Payment Amount |
1124.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
300 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
288343.25 |
Total Medical Medicare Allowed Amount |
36001.79 |
Total Medical Medicare Payment Amount |
28427.88 |
Total Medical Medicare Standardized Payment Amount |
29136.46 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
77 |
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 |
193 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.2773 |