National Provider Identifier [NPI]: |
1649371642 |
Last Name Of The Provider |
ALLEN |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
39000 BOB HOPE DR |
Street Address 2 Of The Provider |
HARRY & DIANE RINKER BUILDING |
City Of The Provider |
RANCHO MIRAGE |
Zip Code Of The Provider |
922703221 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
3463 |
Number Of Medicare Beneficiaries |
955 |
Total Submitted Charge Amount |
507048.53 |
Total Medicare Allowed Amount |
138409.29 |
Total Medicare Payment Amount |
96949.37 |
Total Medicare Standardized Payment Amount |
111963.6 |
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 |
44 |
Number Of Medical Services |
3463 |
Number Of Medicare Beneficiaries With Medical Services |
955 |
Total Medical Submitted Charge Amount |
507048.53 |
Total Medical Medicare Allowed Amount |
138409.29 |
Total Medical Medicare Payment Amount |
96949.37 |
Total Medical Medicare Standardized Payment Amount |
111963.6 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
411 |
Number Of Beneficiaries Age 75 to 84 |
359 |
Number Of Beneficiaries Age Greater 84 |
138 |
Number Of Female Beneficiaries |
526 |
Number Of Male Beneficiaries |
429 |
Number Of Non Hispanic White Beneficiaries |
886 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
889 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0985 |