National Provider Identifier [NPI]: |
1447242607 |
Last Name Of The Provider |
HONGYOK |
First Name Of The Provider |
USA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
450 S WILLARD ST |
Street Address 2 Of The Provider |
SUITE 115 |
City Of The Provider |
COTTONWOOD |
Zip Code Of The Provider |
863266743 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
2808 |
Number Of Medicare Beneficiaries |
360 |
Total Submitted Charge Amount |
366652.6 |
Total Medicare Allowed Amount |
122486.66 |
Total Medicare Payment Amount |
86879.37 |
Total Medicare Standardized Payment Amount |
102450.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
1119 |
Number Of Medicare Beneficiaries With Drug Services |
77 |
Total Drug Submitted ChargeAmount |
56045.6 |
Total Drug Medicare AllowedAmount |
17158.96 |
Total Drug Medicare PaymentAmount |
13884.88 |
Total Drug Medicare Standardized Payment Amount |
13884.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
1689 |
Number Of Medicare Beneficiaries With Medical Services |
360 |
Total Medical Submitted Charge Amount |
310607 |
Total Medical Medicare Allowed Amount |
105327.7 |
Total Medical Medicare Payment Amount |
72994.49 |
Total Medical Medicare Standardized Payment Amount |
88565.82 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
173 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
211 |
Number Of Male Beneficiaries |
149 |
Number Of Non Hispanic White Beneficiaries |
307 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
308 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0302 |