National Provider Identifier [NPI]: |
1063751386 |
Last Name Of The Provider |
DILLARD |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
822 KUMHO DR |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
FAIRLAWN |
Zip Code Of The Provider |
443339297 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
1126 |
Number Of Medicare Beneficiaries |
476 |
Total Submitted Charge Amount |
122524.01 |
Total Medicare Allowed Amount |
69670.31 |
Total Medicare Payment Amount |
53436.48 |
Total Medicare Standardized Payment Amount |
64232.42 |
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 |
1126 |
Number Of Medicare Beneficiaries With Medical Services |
476 |
Total Medical Submitted Charge Amount |
122524.01 |
Total Medical Medicare Allowed Amount |
69670.31 |
Total Medical Medicare Payment Amount |
53436.48 |
Total Medical Medicare Standardized Payment Amount |
64232.42 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
230 |
Number Of Non Hispanic White Beneficiaries |
391 |
Number Of Black or African American Beneficiaries |
72 |
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 |
345 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
30 |
Average HCC Risk Score Of Beneficiaries |
2.208 |