National Provider Identifier [NPI]: |
1942200019 |
Last Name Of The Provider |
PAQUETTE |
First Name Of The Provider |
RAYMOND |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 E COURT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEGUIN |
Zip Code Of The Provider |
781555129 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
290 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
16594 |
Total Medicare Allowed Amount |
13914.67 |
Total Medicare Payment Amount |
8891.8 |
Total Medicare Standardized Payment Amount |
10438.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
61 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
455 |
Total Drug Medicare AllowedAmount |
397.27 |
Total Drug Medicare PaymentAmount |
241.81 |
Total Drug Medicare Standardized Payment Amount |
241.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
229 |
Number Of Medicare Beneficiaries With Medical Services |
142 |
Total Medical Submitted Charge Amount |
16139 |
Total Medical Medicare Allowed Amount |
13517.4 |
Total Medical Medicare Payment Amount |
8649.99 |
Total Medical Medicare Standardized Payment Amount |
10197.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
96 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0259 |