National Provider Identifier [NPI]: |
1497088025 |
Last Name Of The Provider |
HEFFNER |
First Name Of The Provider |
KELLY |
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 |
9104 BABCOCK BLVD |
Street Address 2 Of The Provider |
SUITE 2120 |
City Of The Provider |
PITTSBURGH |
Zip Code Of The Provider |
152375818 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
115 |
Number Of Medicare Beneficiaries |
64 |
Total Submitted Charge Amount |
16445 |
Total Medicare Allowed Amount |
10118.52 |
Total Medicare Payment Amount |
7482.71 |
Total Medicare Standardized Payment Amount |
9093.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
290 |
Total Drug Medicare AllowedAmount |
215.27 |
Total Drug Medicare PaymentAmount |
164.49 |
Total Drug Medicare Standardized Payment Amount |
164.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
5 |
Number Of Medical Services |
96 |
Number Of Medicare Beneficiaries With Medical Services |
64 |
Total Medical Submitted Charge Amount |
16155 |
Total Medical Medicare Allowed Amount |
9903.25 |
Total Medical Medicare Payment Amount |
7318.22 |
Total Medical Medicare Standardized Payment Amount |
8928.61 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
48 |
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 |
|
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 |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1889 |