National Provider Identifier [NPI]: |
1689003956 |
Last Name Of The Provider |
RYAN |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6567 E CARONDELET DR |
Street Address 2 Of The Provider |
SUITE 305 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857106152 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
171 |
Number Of Medicare Beneficiaries |
77 |
Total Submitted Charge Amount |
115512.89 |
Total Medicare Allowed Amount |
18911.66 |
Total Medicare Payment Amount |
14493.57 |
Total Medicare Standardized Payment Amount |
13973.84 |
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 |
54 |
Number Of Medical Services |
171 |
Number Of Medicare Beneficiaries With Medical Services |
77 |
Total Medical Submitted Charge Amount |
115512.89 |
Total Medical Medicare Allowed Amount |
18911.66 |
Total Medical Medicare Payment Amount |
14493.57 |
Total Medical Medicare Standardized Payment Amount |
13973.84 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
41 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
63 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
36 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
1.0914 |