National Provider Identifier [NPI]: |
1326391541 |
Last Name Of The Provider |
PHELPS |
First Name Of The Provider |
ZOEY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5665 NEW NORTHSIDE DR NW STE 320 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303285834 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
268 |
Number Of Medicare Beneficiaries |
205 |
Total Submitted Charge Amount |
161047 |
Total Medicare Allowed Amount |
19969.47 |
Total Medicare Payment Amount |
14494.98 |
Total Medicare Standardized Payment Amount |
17943.78 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
103 |
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 |
92 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7291 |