National Provider Identifier [NPI]: |
1598935751 |
Last Name Of The Provider |
WARREN |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
128 MEDICAL CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WINCHESTER |
Zip Code Of The Provider |
226013322 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
1515 |
Number Of Medicare Beneficiaries |
401 |
Total Submitted Charge Amount |
229621 |
Total Medicare Allowed Amount |
86598.21 |
Total Medicare Payment Amount |
63155.58 |
Total Medicare Standardized Payment Amount |
71713.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
462 |
Number Of Medicare Beneficiaries With Drug Services |
205 |
Total Drug Submitted ChargeAmount |
65773 |
Total Drug Medicare AllowedAmount |
32807.88 |
Total Drug Medicare PaymentAmount |
24999.68 |
Total Drug Medicare Standardized Payment Amount |
24999.68 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
1053 |
Number Of Medicare Beneficiaries With Medical Services |
401 |
Total Medical Submitted Charge Amount |
163848 |
Total Medical Medicare Allowed Amount |
53790.33 |
Total Medical Medicare Payment Amount |
38155.9 |
Total Medical Medicare Standardized Payment Amount |
46714.05 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
257 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
375 |
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 |
363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0271 |