National Provider Identifier [NPI]: |
1851329163 |
Last Name Of The Provider |
GAMMIE |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
105 4TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
EAST BERLIN |
Zip Code Of The Provider |
173169638 |
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 |
24 |
Number Of Services |
391 |
Number Of Medicare Beneficiaries |
205 |
Total Submitted Charge Amount |
27305 |
Total Medicare Allowed Amount |
19289.11 |
Total Medicare Payment Amount |
12917.66 |
Total Medicare Standardized Payment Amount |
16210.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
613 |
Total Drug Medicare AllowedAmount |
481.69 |
Total Drug Medicare PaymentAmount |
431.26 |
Total Drug Medicare Standardized Payment Amount |
431.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
366 |
Number Of Medicare Beneficiaries With Medical Services |
205 |
Total Medical Submitted Charge Amount |
26692 |
Total Medical Medicare Allowed Amount |
18807.42 |
Total Medical Medicare Payment Amount |
12486.4 |
Total Medical Medicare Standardized Payment Amount |
15778.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
77 |
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 |
169 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0049 |