National Provider Identifier [NPI]: |
1962781062 |
Last Name Of The Provider |
DAVIES |
First Name Of The Provider |
CYNTHIA |
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 |
4 DANA LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
BERWICK |
Zip Code Of The Provider |
039012767 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
462 |
Number Of Medicare Beneficiaries |
374 |
Total Submitted Charge Amount |
74112.61 |
Total Medicare Allowed Amount |
20764.33 |
Total Medicare Payment Amount |
13945.07 |
Total Medicare Standardized Payment Amount |
17445.86 |
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 |
29 |
Number Of Medical Services |
462 |
Number Of Medicare Beneficiaries With Medical Services |
374 |
Total Medical Submitted Charge Amount |
74112.61 |
Total Medical Medicare Allowed Amount |
20764.33 |
Total Medical Medicare Payment Amount |
13945.07 |
Total Medical Medicare Standardized Payment Amount |
17445.86 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
361 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
293 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0585 |