National Provider Identifier [NPI]: |
1821313651 |
Last Name Of The Provider |
TAYLOR |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1205 HEALTH CENTER PKWY STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
YUKON |
Zip Code Of The Provider |
730996396 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
468 |
Number Of Medicare Beneficiaries |
209 |
Total Submitted Charge Amount |
48791 |
Total Medicare Allowed Amount |
22277.55 |
Total Medicare Payment Amount |
16769.05 |
Total Medicare Standardized Payment Amount |
21695.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
44 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
1874 |
Total Drug Medicare AllowedAmount |
1222.94 |
Total Drug Medicare PaymentAmount |
999.77 |
Total Drug Medicare Standardized Payment Amount |
999.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
424 |
Number Of Medicare Beneficiaries With Medical Services |
209 |
Total Medical Submitted Charge Amount |
46917 |
Total Medical Medicare Allowed Amount |
21054.61 |
Total Medical Medicare Payment Amount |
15769.28 |
Total Medical Medicare Standardized Payment Amount |
20695.82 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
75 |
Number Of Non Hispanic White Beneficiaries |
197 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0259 |