National Provider Identifier [NPI]: |
1104178805 |
Last Name Of The Provider |
HEAD |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1920 SW 20TH PL |
Street Address 2 Of The Provider |
#100 |
City Of The Provider |
OCALA |
Zip Code Of The Provider |
344717881 |
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 |
48 |
Number Of Services |
1136 |
Number Of Medicare Beneficiaries |
605 |
Total Submitted Charge Amount |
379337.22 |
Total Medicare Allowed Amount |
79504.4 |
Total Medicare Payment Amount |
60163.81 |
Total Medicare Standardized Payment Amount |
71361.83 |
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 |
48 |
Number Of Medical Services |
1136 |
Number Of Medicare Beneficiaries With Medical Services |
605 |
Total Medical Submitted Charge Amount |
379337.22 |
Total Medical Medicare Allowed Amount |
79504.4 |
Total Medical Medicare Payment Amount |
60163.81 |
Total Medical Medicare Standardized Payment Amount |
71361.83 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
210 |
Number Of Beneficiaries Age 75 to 84 |
218 |
Number Of Beneficiaries Age Greater 84 |
110 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
320 |
Number Of Non Hispanic White Beneficiaries |
533 |
Number Of Black or African American Beneficiaries |
42 |
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 |
471 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.1087 |