National Provider Identifier [NPI]: |
1922006170 |
Last Name Of The Provider |
WERNON |
First Name Of The Provider |
HARLEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4500 W NEWBERRY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326072245 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
384 |
Number Of Medicare Beneficiaries |
274 |
Total Submitted Charge Amount |
433415.98 |
Total Medicare Allowed Amount |
58042.44 |
Total Medicare Payment Amount |
45176.77 |
Total Medicare Standardized Payment Amount |
44179.65 |
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 |
60 |
Number Of Medical Services |
384 |
Number Of Medicare Beneficiaries With Medical Services |
274 |
Total Medical Submitted Charge Amount |
433415.98 |
Total Medical Medicare Allowed Amount |
58042.44 |
Total Medical Medicare Payment Amount |
45176.77 |
Total Medical Medicare Standardized Payment Amount |
44179.65 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
166 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
232 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.0988 |