National Provider Identifier [NPI]: |
1891757050 |
Last Name Of The Provider |
KERR |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
P.A.C. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20117 EUREKA RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAYLOR |
Zip Code Of The Provider |
481805320 |
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 |
14 |
Number Of Services |
429 |
Number Of Medicare Beneficiaries |
412 |
Total Submitted Charge Amount |
57985 |
Total Medicare Allowed Amount |
32130.1 |
Total Medicare Payment Amount |
24921.48 |
Total Medicare Standardized Payment Amount |
28461.42 |
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 |
14 |
Number Of Medical Services |
429 |
Number Of Medicare Beneficiaries With Medical Services |
412 |
Total Medical Submitted Charge Amount |
57985 |
Total Medical Medicare Allowed Amount |
32130.1 |
Total Medical Medicare Payment Amount |
24921.48 |
Total Medical Medicare Standardized Payment Amount |
28461.42 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
244 |
Number Of Male Beneficiaries |
168 |
Number Of Non Hispanic White Beneficiaries |
293 |
Number Of Black or African American Beneficiaries |
91 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
287 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.9397 |