National Provider Identifier [NPI]: |
1487805479 |
Last Name Of The Provider |
HELD |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3500 S LAFOUNTAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KOKOMO |
Zip Code Of The Provider |
469023803 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
402 |
Number Of Medicare Beneficiaries |
327 |
Total Submitted Charge Amount |
389192 |
Total Medicare Allowed Amount |
36106.67 |
Total Medicare Payment Amount |
25675 |
Total Medicare Standardized Payment Amount |
31794.89 |
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 |
29 |
Number Of Medical Services |
402 |
Number Of Medicare Beneficiaries With Medical Services |
327 |
Total Medical Submitted Charge Amount |
389192 |
Total Medical Medicare Allowed Amount |
36106.67 |
Total Medical Medicare Payment Amount |
25675 |
Total Medical Medicare Standardized Payment Amount |
31794.89 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
290 |
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 |
189 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4521 |