National Provider Identifier [NPI]: |
1033357116 |
Last Name Of The Provider |
SEITHEL |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 SHIRCLIFF WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322044748 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
417 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
138859 |
Total Medicare Allowed Amount |
44269.05 |
Total Medicare Payment Amount |
33710 |
Total Medicare Standardized Payment Amount |
41345.01 |
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 |
18 |
Number Of Medical Services |
417 |
Number Of Medicare Beneficiaries With Medical Services |
377 |
Total Medical Submitted Charge Amount |
138859 |
Total Medical Medicare Allowed Amount |
44269.05 |
Total Medical Medicare Payment Amount |
33710 |
Total Medical Medicare Standardized Payment Amount |
41345.01 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
185 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
326 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
190 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.8893 |