National Provider Identifier [NPI]: |
1174874382 |
Last Name Of The Provider |
VAVREK |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
285 E STATE ST |
Street Address 2 Of The Provider |
SUITE 260 |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432154354 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
288 |
Number Of Medicare Beneficiaries |
230 |
Total Submitted Charge Amount |
192135 |
Total Medicare Allowed Amount |
29949.82 |
Total Medicare Payment Amount |
22416 |
Total Medicare Standardized Payment Amount |
27169.65 |
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 |
13 |
Number Of Medical Services |
288 |
Number Of Medicare Beneficiaries With Medical Services |
230 |
Total Medical Submitted Charge Amount |
192135 |
Total Medical Medicare Allowed Amount |
29949.82 |
Total Medical Medicare Payment Amount |
22416 |
Total Medical Medicare Standardized Payment Amount |
27169.65 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
219 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
124 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7076 |