National Provider Identifier [NPI]: |
1487785820 |
Last Name Of The Provider |
JAHJAH |
First Name Of The Provider |
SUZANNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 E MICHIGAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANSING |
Zip Code Of The Provider |
489121811 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
217 |
Number Of Medicare Beneficiaries |
183 |
Total Submitted Charge Amount |
121287 |
Total Medicare Allowed Amount |
21898.09 |
Total Medicare Payment Amount |
16244.03 |
Total Medicare Standardized Payment Amount |
19634.75 |
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 |
21 |
Number Of Medical Services |
217 |
Number Of Medicare Beneficiaries With Medical Services |
183 |
Total Medical Submitted Charge Amount |
121287 |
Total Medical Medicare Allowed Amount |
21898.09 |
Total Medical Medicare Payment Amount |
16244.03 |
Total Medical Medicare Standardized Payment Amount |
19634.75 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
125 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
109 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
116 |
Number Of Black or African American Beneficiaries |
52 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4202 |