National Provider Identifier [NPI]: |
1063440386 |
Last Name Of The Provider |
MCDONALD |
First Name Of The Provider |
ANN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 UNIVERSITY BLVD E |
Street Address 2 Of The Provider |
SUITE 808 |
City Of The Provider |
TUSCALOOSA |
Zip Code Of The Provider |
354012086 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
451 |
Number Of Medicare Beneficiaries |
278 |
Total Submitted Charge Amount |
602565.5 |
Total Medicare Allowed Amount |
50935.46 |
Total Medicare Payment Amount |
39728.57 |
Total Medicare Standardized Payment Amount |
51133.18 |
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 |
73 |
Number Of Medical Services |
451 |
Number Of Medicare Beneficiaries With Medical Services |
278 |
Total Medical Submitted Charge Amount |
602565.5 |
Total Medical Medicare Allowed Amount |
50935.46 |
Total Medical Medicare Payment Amount |
39728.57 |
Total Medical Medicare Standardized Payment Amount |
51133.18 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
166 |
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 |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.6192 |