National Provider Identifier [NPI]: |
1467419937 |
Last Name Of The Provider |
CITY |
First Name Of The Provider |
REGAN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3501 N SCOTTSDALE RD |
Street Address 2 Of The Provider |
#130 |
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
852515648 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
400 |
Number Of Medicare Beneficiaries |
197 |
Total Submitted Charge Amount |
184521 |
Total Medicare Allowed Amount |
33076.01 |
Total Medicare Payment Amount |
24985.99 |
Total Medicare Standardized Payment Amount |
30301.69 |
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 |
22 |
Number Of Medical Services |
400 |
Number Of Medicare Beneficiaries With Medical Services |
197 |
Total Medical Submitted Charge Amount |
184521 |
Total Medical Medicare Allowed Amount |
33076.01 |
Total Medical Medicare Payment Amount |
24985.99 |
Total Medical Medicare Standardized Payment Amount |
30301.69 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
176 |
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 |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
33 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.3479 |