National Provider Identifier [NPI]: |
1487728747 |
Last Name Of The Provider |
FLAMME |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8901 W DODGE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
OMAHA |
Zip Code Of The Provider |
681143327 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
2680 |
Number Of Medicare Beneficiaries |
624 |
Total Submitted Charge Amount |
212897.4 |
Total Medicare Allowed Amount |
73755.96 |
Total Medicare Payment Amount |
52950.6 |
Total Medicare Standardized Payment Amount |
67587.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
353 |
Number Of Medicare Beneficiaries With Drug Services |
92 |
Total Drug Submitted ChargeAmount |
2857 |
Total Drug Medicare AllowedAmount |
1226.14 |
Total Drug Medicare PaymentAmount |
977.69 |
Total Drug Medicare Standardized Payment Amount |
977.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
2327 |
Number Of Medicare Beneficiaries With Medical Services |
624 |
Total Medical Submitted Charge Amount |
210040.4 |
Total Medical Medicare Allowed Amount |
72529.82 |
Total Medical Medicare Payment Amount |
51972.91 |
Total Medical Medicare Standardized Payment Amount |
66609.5 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
234 |
Number Of Beneficiaries Age 75 to 84 |
199 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
458 |
Number Of Male Beneficiaries |
166 |
Number Of Non Hispanic White Beneficiaries |
577 |
Number Of Black or African American Beneficiaries |
27 |
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 |
554 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
70 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1341 |