National Provider Identifier [NPI]: |
1063496255 |
Last Name Of The Provider |
RANDALL |
First Name Of The Provider |
AMBER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
77 W FOREST AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
FLAGSTAFF |
Zip Code Of The Provider |
860011479 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
9036 |
Number Of Medicare Beneficiaries |
963 |
Total Submitted Charge Amount |
2960109.33 |
Total Medicare Allowed Amount |
660853.75 |
Total Medicare Payment Amount |
493731.91 |
Total Medicare Standardized Payment Amount |
494313.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
3709 |
Number Of Medicare Beneficiaries With Drug Services |
225 |
Total Drug Submitted ChargeAmount |
104578.45 |
Total Drug Medicare AllowedAmount |
39845.85 |
Total Drug Medicare PaymentAmount |
30801.71 |
Total Drug Medicare Standardized Payment Amount |
30801.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
5327 |
Number Of Medicare Beneficiaries With Medical Services |
963 |
Total Medical Submitted Charge Amount |
2855530.88 |
Total Medical Medicare Allowed Amount |
621007.9 |
Total Medical Medicare Payment Amount |
462930.2 |
Total Medical Medicare Standardized Payment Amount |
463511.95 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
535 |
Number Of Beneficiaries Age 75 to 84 |
289 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
600 |
Number Of Male Beneficiaries |
363 |
Number Of Non Hispanic White Beneficiaries |
859 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
28 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
886 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.9343 |