National Provider Identifier [NPI]: |
1932285285 |
Last Name Of The Provider |
OAKS |
First Name Of The Provider |
JESSICA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
44201 DEQUINDRE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TROY |
Zip Code Of The Provider |
480851117 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
229 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
32084 |
Total Medicare Allowed Amount |
20430.58 |
Total Medicare Payment Amount |
16017.89 |
Total Medicare Standardized Payment Amount |
18134.57 |
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 |
6 |
Number Of Medical Services |
229 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
32084 |
Total Medical Medicare Allowed Amount |
20430.58 |
Total Medical Medicare Payment Amount |
16017.89 |
Total Medical Medicare Standardized Payment Amount |
18134.57 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
205 |
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 |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4294 |