National Provider Identifier [NPI]: |
1386899193 |
Last Name Of The Provider |
DEARMONT |
First Name Of The Provider |
RACHEL |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3015 N BALLAS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631312329 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
279 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
75715 |
Total Medicare Allowed Amount |
15218.57 |
Total Medicare Payment Amount |
11855.12 |
Total Medicare Standardized Payment Amount |
14083.62 |
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 |
17 |
Number Of Medical Services |
279 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
75715 |
Total Medical Medicare Allowed Amount |
15218.57 |
Total Medical Medicare Payment Amount |
11855.12 |
Total Medical Medicare Standardized Payment Amount |
14083.62 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
209 |
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 |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
3.2336 |