National Provider Identifier [NPI]: |
1871929257 |
Last Name Of The Provider |
TRAVNIKAR |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
750 STEPHENSON HWY |
Street Address 2 Of The Provider |
BEAUMONT PAYOR CONTRACT SERVICES |
City Of The Provider |
TROY |
Zip Code Of The Provider |
480831103 |
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 |
9 |
Number Of Services |
53 |
Number Of Medicare Beneficiaries |
47 |
Total Submitted Charge Amount |
10656 |
Total Medicare Allowed Amount |
4846.48 |
Total Medicare Payment Amount |
3799.73 |
Total Medicare Standardized Payment Amount |
4291.71 |
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 |
9 |
Number Of Medical Services |
53 |
Number Of Medicare Beneficiaries With Medical Services |
47 |
Total Medical Submitted Charge Amount |
10656 |
Total Medical Medicare Allowed Amount |
4846.48 |
Total Medical Medicare Payment Amount |
3799.73 |
Total Medical Medicare Standardized Payment Amount |
4291.71 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
14 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
25 |
Number Of Male Beneficiaries |
22 |
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 |
36 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
26 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.4966 |