National Provider Identifier [NPI]: |
1144229048 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5251 CLYDE PARK SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
WYOMING |
Zip Code Of The Provider |
49509 |
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 |
45 |
Number Of Services |
320 |
Number Of Medicare Beneficiaries |
64 |
Total Submitted Charge Amount |
18537.45 |
Total Medicare Allowed Amount |
10255.97 |
Total Medicare Payment Amount |
7800.95 |
Total Medicare Standardized Payment Amount |
9255.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
74 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
1130.7 |
Total Drug Medicare AllowedAmount |
1090.38 |
Total Drug Medicare PaymentAmount |
1043.55 |
Total Drug Medicare Standardized Payment Amount |
1043.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
246 |
Number Of Medicare Beneficiaries With Medical Services |
64 |
Total Medical Submitted Charge Amount |
17406.75 |
Total Medical Medicare Allowed Amount |
9165.59 |
Total Medical Medicare Payment Amount |
6757.4 |
Total Medical Medicare Standardized Payment Amount |
8211.63 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
30 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
0 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
17 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8524 |