National Provider Identifier [NPI]: |
1356391031 |
Last Name Of The Provider |
SAVAGE |
First Name Of The Provider |
RACHEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10220 ALLIANCE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLUE ASH |
Zip Code Of The Provider |
452424710 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
447 |
Number Of Medicare Beneficiaries |
30 |
Total Submitted Charge Amount |
21319 |
Total Medicare Allowed Amount |
11550.91 |
Total Medicare Payment Amount |
9094.67 |
Total Medicare Standardized Payment Amount |
9466.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
386 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
12360 |
Total Drug Medicare AllowedAmount |
9254.89 |
Total Drug Medicare PaymentAmount |
7255.83 |
Total Drug Medicare Standardized Payment Amount |
7255.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
61 |
Number Of Medicare Beneficiaries With Medical Services |
30 |
Total Medical Submitted Charge Amount |
8959 |
Total Medical Medicare Allowed Amount |
2296.02 |
Total Medical Medicare Payment Amount |
1838.84 |
Total Medical Medicare Standardized Payment Amount |
2210.48 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
12 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
12 |
Number Of Male Beneficiaries |
18 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.323 |