National Provider Identifier [NPI]: |
1417972910 |
Last Name Of The Provider |
NOGAN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9901 MEDICAL CENTER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKVILLE |
Zip Code Of The Provider |
208503357 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
399 |
Number Of Medicare Beneficiaries |
321 |
Total Submitted Charge Amount |
203420.2 |
Total Medicare Allowed Amount |
39400.4 |
Total Medicare Payment Amount |
29860.51 |
Total Medicare Standardized Payment Amount |
32620.21 |
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 |
25 |
Number Of Medical Services |
399 |
Number Of Medicare Beneficiaries With Medical Services |
321 |
Total Medical Submitted Charge Amount |
203420.2 |
Total Medical Medicare Allowed Amount |
39400.4 |
Total Medical Medicare Payment Amount |
29860.51 |
Total Medical Medicare Standardized Payment Amount |
32620.21 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
207 |
Number Of Black or African American Beneficiaries |
68 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4647 |