National Provider Identifier [NPI]: |
1649222985 |
Last Name Of The Provider |
PREDMORE |
First Name Of The Provider |
TORRI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3550 BUSCHWOOD PARK DR |
Street Address 2 Of The Provider |
SUITE 350 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336184461 |
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 |
25 |
Number Of Services |
533 |
Number Of Medicare Beneficiaries |
439 |
Total Submitted Charge Amount |
540287 |
Total Medicare Allowed Amount |
50085.86 |
Total Medicare Payment Amount |
38007.62 |
Total Medicare Standardized Payment Amount |
42627.92 |
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 |
25 |
Number Of Medical Services |
533 |
Number Of Medicare Beneficiaries With Medical Services |
439 |
Total Medical Submitted Charge Amount |
540287 |
Total Medical Medicare Allowed Amount |
50085.86 |
Total Medical Medicare Payment Amount |
38007.62 |
Total Medical Medicare Standardized Payment Amount |
42627.92 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
173 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
265 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
386 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
347 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2165 |