National Provider Identifier [NPI]: |
1235329863 |
Last Name Of The Provider |
MCCLENDON |
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 |
2000 W. BETHANY HOME ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
85015 |
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 |
48 |
Number Of Services |
824 |
Number Of Medicare Beneficiaries |
223 |
Total Submitted Charge Amount |
57185 |
Total Medicare Allowed Amount |
31189.04 |
Total Medicare Payment Amount |
20084.96 |
Total Medicare Standardized Payment Amount |
24513.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
405 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
3549 |
Total Drug Medicare AllowedAmount |
519.17 |
Total Drug Medicare PaymentAmount |
380.64 |
Total Drug Medicare Standardized Payment Amount |
380.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
419 |
Number Of Medicare Beneficiaries With Medical Services |
223 |
Total Medical Submitted Charge Amount |
53636 |
Total Medical Medicare Allowed Amount |
30669.87 |
Total Medical Medicare Payment Amount |
19704.32 |
Total Medical Medicare Standardized Payment Amount |
24132.61 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
188 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
17 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
184 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9901 |