National Provider Identifier [NPI]: |
1831325034 |
Last Name Of The Provider |
PATTERSON |
First Name Of The Provider |
TETYANA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2601 E ROOSEVELT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850084973 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
325 |
Number Of Medicare Beneficiaries |
123 |
Total Submitted Charge Amount |
43298.58 |
Total Medicare Allowed Amount |
26582 |
Total Medicare Payment Amount |
20756.65 |
Total Medicare Standardized Payment Amount |
20812.04 |
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 |
17 |
Number Of Medical Services |
325 |
Number Of Medicare Beneficiaries With Medical Services |
123 |
Total Medical Submitted Charge Amount |
43298.58 |
Total Medical Medicare Allowed Amount |
26582 |
Total Medical Medicare Payment Amount |
20756.65 |
Total Medical Medicare Standardized Payment Amount |
20812.04 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
41 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
62 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
31 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
41 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.9104 |