National Provider Identifier [NPI]: |
1265523526 |
Last Name Of The Provider |
SPEED |
First Name Of The Provider |
J |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
405 S MAIN AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
MONAHANS |
Zip Code Of The Provider |
797564506 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
868 |
Number Of Medicare Beneficiaries |
584 |
Total Submitted Charge Amount |
113693.78 |
Total Medicare Allowed Amount |
46242.34 |
Total Medicare Payment Amount |
34717.68 |
Total Medicare Standardized Payment Amount |
42304.81 |
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 |
38 |
Number Of Medical Services |
868 |
Number Of Medicare Beneficiaries With Medical Services |
584 |
Total Medical Submitted Charge Amount |
113693.78 |
Total Medical Medicare Allowed Amount |
46242.34 |
Total Medical Medicare Payment Amount |
34717.68 |
Total Medical Medicare Standardized Payment Amount |
42304.81 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
216 |
Number Of Beneficiaries Age 75 to 84 |
169 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
282 |
Number Of Non Hispanic White Beneficiaries |
550 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
466 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0568 |