National Provider Identifier [NPI]: |
1134374655 |
Last Name Of The Provider |
MORRIS |
First Name Of The Provider |
AMBER |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 SAINT SEBASTIAN WAY |
Street Address 2 Of The Provider |
SUITE 4C |
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309012643 |
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 |
30 |
Number Of Services |
1018 |
Number Of Medicare Beneficiaries |
319 |
Total Submitted Charge Amount |
109251 |
Total Medicare Allowed Amount |
38259.28 |
Total Medicare Payment Amount |
29269.03 |
Total Medicare Standardized Payment Amount |
35858.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
68 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
2859 |
Total Drug Medicare AllowedAmount |
1262.11 |
Total Drug Medicare PaymentAmount |
1233.88 |
Total Drug Medicare Standardized Payment Amount |
1233.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
950 |
Number Of Medicare Beneficiaries With Medical Services |
319 |
Total Medical Submitted Charge Amount |
106392 |
Total Medical Medicare Allowed Amount |
36997.17 |
Total Medical Medicare Payment Amount |
28035.15 |
Total Medical Medicare Standardized Payment Amount |
34624.51 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
185 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
286 |
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 |
291 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1888 |