National Provider Identifier [NPI]: |
1043507528 |
Last Name Of The Provider |
BIRA |
First Name Of The Provider |
EMILY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1031 BELLEVUE AVE |
Street Address 2 Of The Provider |
SUITE 280 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631171818 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
407 |
Number Of Medicare Beneficiaries |
91 |
Total Submitted Charge Amount |
28979 |
Total Medicare Allowed Amount |
13303.82 |
Total Medicare Payment Amount |
9339.77 |
Total Medicare Standardized Payment Amount |
11535.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
886 |
Total Drug Medicare AllowedAmount |
423.33 |
Total Drug Medicare PaymentAmount |
408.96 |
Total Drug Medicare Standardized Payment Amount |
408.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
389 |
Number Of Medicare Beneficiaries With Medical Services |
91 |
Total Medical Submitted Charge Amount |
28093 |
Total Medical Medicare Allowed Amount |
12880.49 |
Total Medical Medicare Payment Amount |
8930.81 |
Total Medical Medicare Standardized Payment Amount |
11126.27 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
78 |
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 |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
27 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9213 |