National Provider Identifier [NPI]: |
1881816718 |
Last Name Of The Provider |
POWERS |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1810 MESQUITE AVENUE |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
LAKE HAVASU CITY |
Zip Code Of The Provider |
864035886 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
3327 |
Number Of Medicare Beneficiaries |
659 |
Total Submitted Charge Amount |
565626.25 |
Total Medicare Allowed Amount |
229715.1 |
Total Medicare Payment Amount |
167377.62 |
Total Medicare Standardized Payment Amount |
170176.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
301 |
Number Of Medicare Beneficiaries With Drug Services |
275 |
Total Drug Submitted ChargeAmount |
13535 |
Total Drug Medicare AllowedAmount |
10048.26 |
Total Drug Medicare PaymentAmount |
9823.02 |
Total Drug Medicare Standardized Payment Amount |
9823.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
3026 |
Number Of Medicare Beneficiaries With Medical Services |
659 |
Total Medical Submitted Charge Amount |
552091.25 |
Total Medical Medicare Allowed Amount |
219666.84 |
Total Medical Medicare Payment Amount |
157554.6 |
Total Medical Medicare Standardized Payment Amount |
160353.2 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
319 |
Number Of Beneficiaries Age 75 to 84 |
226 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
374 |
Number Of Non Hispanic White Beneficiaries |
619 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
644 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8702 |