National Provider Identifier [NPI]: |
1285601559 |
Last Name Of The Provider |
FILS |
First Name Of The Provider |
RODNEY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
761 EDGEWOOD AVE N |
Street Address 2 Of The Provider |
COMMONWEALTH FAMILY PRACTICE CENTER |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322543013 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
424 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
47701 |
Total Medicare Allowed Amount |
21538.28 |
Total Medicare Payment Amount |
16083.58 |
Total Medicare Standardized Payment Amount |
19081.91 |
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 |
6 |
Number Of Medical Services |
424 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
47701 |
Total Medical Medicare Allowed Amount |
21538.28 |
Total Medical Medicare Payment Amount |
16083.58 |
Total Medical Medicare Standardized Payment Amount |
19081.91 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
112 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
86 |
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 |
36 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
19 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7057 |