Medicare Facts for Jill M. Ellis, PA


National Provider Identifier [NPI]: 1720052483
Last Name Of The Provider ELLIS
First Name Of The Provider JILL
Middle Initial Of The Provider M
Credentials Of The Provider P.A.
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 4967 CROOKS RD STE 130
Street Address 2 Of The Provider
City Of The Provider TROY
Zip Code Of The Provider 480985812
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 5
Number Of Services 28
Number Of Medicare Beneficiaries 28
Total Submitted Charge Amount 3698
Total Medicare Allowed Amount 2030.42
Total Medicare Payment Amount 1591.78
Total Medicare Standardized Payment Amount 1911.83
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 5
Number Of Medical Services 28
Number Of Medicare Beneficiaries With Medical Services 28
Total Medical Submitted Charge Amount 3698
Total Medical Medicare Allowed Amount 2030.42
Total Medical Medicare Payment Amount 1591.78
Total Medical Medicare Standardized Payment Amount 1911.83
Average Age Of Beneficiaries 58
Number Of Beneficiaries Age Less65 17
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 12
Number Of Male Beneficiaries 16
Number Of Non Hispanic White Beneficiaries
Number Of Black or African American Beneficiaries
Number Of AsianPacific Islander Beneficiaries
Number Of Hispanic Beneficiaries
Number Of American Indian Alaska Native Beneficiaries
Number Of Beneficiaries With Race Not Else where Classified
Number Of Beneficiaries With Medicare Only Entitlement
Number Of Beneficiaries With Medicare Medicaid Entitlement
Percent Of With Atrial Fibrillation 0
Percent Of With Alzheimers Disease or Dementia
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 75
Percent Of With Diabetes 43
Percent Of With Hyperlipidemia 50
Percent Of With Hypertension 57
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis
Percent Of With Schizophrenia Other PsychoticDisorders 75
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 2.0079

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