National Provider Identifier [NPI]: |
1851359616 |
Last Name Of The Provider |
GOLDING |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1450 S DOBSON RD |
Street Address 2 Of The Provider |
SUITE B122 |
City Of The Provider |
MESA |
Zip Code Of The Provider |
852024712 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
483 |
Number Of Medicare Beneficiaries |
122 |
Total Submitted Charge Amount |
81867.61 |
Total Medicare Allowed Amount |
24697.74 |
Total Medicare Payment Amount |
19248.33 |
Total Medicare Standardized Payment Amount |
20631.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
197 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
15487.09 |
Total Drug Medicare AllowedAmount |
5626.23 |
Total Drug Medicare PaymentAmount |
4407.53 |
Total Drug Medicare Standardized Payment Amount |
4407.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
286 |
Number Of Medicare Beneficiaries With Medical Services |
122 |
Total Medical Submitted Charge Amount |
66380.52 |
Total Medical Medicare Allowed Amount |
19071.51 |
Total Medical Medicare Payment Amount |
14840.8 |
Total Medical Medicare Standardized Payment Amount |
16223.54 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
73 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
89 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
88 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6015 |