National Provider Identifier [NPI]: |
1013909282 |
Last Name Of The Provider |
HOLBROOK |
First Name Of The Provider |
ROBIN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
PAC |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7629 KY ROUTE 979 |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRETHEL |
Zip Code Of The Provider |
416316304 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
1449 |
Number Of Medicare Beneficiaries |
229 |
Total Submitted Charge Amount |
60148 |
Total Medicare Allowed Amount |
12249.13 |
Total Medicare Payment Amount |
10520.62 |
Total Medicare Standardized Payment Amount |
9972.43 |
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 |
38 |
Number Of Medical Services |
1449 |
Number Of Medicare Beneficiaries With Medical Services |
229 |
Total Medical Submitted Charge Amount |
60148 |
Total Medical Medicare Allowed Amount |
12249.13 |
Total Medical Medicare Payment Amount |
10520.62 |
Total Medical Medicare Standardized Payment Amount |
9972.43 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
124 |
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 |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9095 |