National Provider Identifier [NPI]: |
1083911911 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 W BELVEDERE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212155216 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
470 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
93479 |
Total Medicare Allowed Amount |
38631.57 |
Total Medicare Payment Amount |
29851.39 |
Total Medicare Standardized Payment Amount |
31609.48 |
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 |
17 |
Number Of Medical Services |
470 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
93479 |
Total Medical Medicare Allowed Amount |
38631.57 |
Total Medical Medicare Payment Amount |
29851.39 |
Total Medical Medicare Standardized Payment Amount |
31609.48 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
172 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
134 |
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 |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
27 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
73 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4372 |