National Provider Identifier [NPI]: |
1932136686 |
Last Name Of The Provider |
PFANNENSTIEL |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
P.A.-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2222 N NEVADA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLORADO SPRINGS |
Zip Code Of The Provider |
809076819 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
166 |
Number Of Medicare Beneficiaries |
144 |
Total Submitted Charge Amount |
55539.25 |
Total Medicare Allowed Amount |
13575.47 |
Total Medicare Payment Amount |
9752.39 |
Total Medicare Standardized Payment Amount |
11644.71 |
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 |
166 |
Number Of Medicare Beneficiaries With Medical Services |
144 |
Total Medical Submitted Charge Amount |
55539.25 |
Total Medical Medicare Allowed Amount |
13575.47 |
Total Medical Medicare Payment Amount |
9752.39 |
Total Medical Medicare Standardized Payment Amount |
11644.71 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
124 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1709 |