National Provider Identifier [NPI]: |
1033300645 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
DELMER |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 JEFFERSON AVE SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495034502 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
528 |
Number Of Medicare Beneficiaries |
371 |
Total Submitted Charge Amount |
148271 |
Total Medicare Allowed Amount |
39000.1 |
Total Medicare Payment Amount |
28767.91 |
Total Medicare Standardized Payment Amount |
35476.65 |
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 |
26 |
Number Of Medical Services |
528 |
Number Of Medicare Beneficiaries With Medical Services |
371 |
Total Medical Submitted Charge Amount |
148271 |
Total Medical Medicare Allowed Amount |
39000.1 |
Total Medical Medicare Payment Amount |
28767.91 |
Total Medical Medicare Standardized Payment Amount |
35476.65 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
216 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
231 |
Number Of Black or African American Beneficiaries |
107 |
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 |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
228 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7977 |