National Provider Identifier [NPI]: |
1821142647 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
PAC |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6501 TRUXTUN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BAKERSFIELD |
Zip Code Of The Provider |
933090633 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
2195 |
Number Of Medicare Beneficiaries |
373 |
Total Submitted Charge Amount |
605069 |
Total Medicare Allowed Amount |
221847.32 |
Total Medicare Payment Amount |
166742.42 |
Total Medicare Standardized Payment Amount |
197225.05 |
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 |
10 |
Number Of Medical Services |
2195 |
Number Of Medicare Beneficiaries With Medical Services |
373 |
Total Medical Submitted Charge Amount |
605069 |
Total Medical Medicare Allowed Amount |
221847.32 |
Total Medical Medicare Payment Amount |
166742.42 |
Total Medical Medicare Standardized Payment Amount |
197225.05 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
248 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
90 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
238 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
43 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.3169 |