National Provider Identifier [NPI]: |
1255762126 |
Last Name Of The Provider |
FAUGHT |
First Name Of The Provider |
AUBREY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1001 N WALDROP DR |
Street Address 2 Of The Provider |
SUITE 403 |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
760124705 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
349 |
Number Of Medicare Beneficiaries |
92 |
Total Submitted Charge Amount |
98811.01 |
Total Medicare Allowed Amount |
30103.72 |
Total Medicare Payment Amount |
23303.44 |
Total Medicare Standardized Payment Amount |
24150.32 |
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 |
349 |
Number Of Medicare Beneficiaries With Medical Services |
92 |
Total Medical Submitted Charge Amount |
98811.01 |
Total Medical Medicare Allowed Amount |
30103.72 |
Total Medical Medicare Payment Amount |
23303.44 |
Total Medical Medicare Standardized Payment Amount |
24150.32 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
27 |
Number Of Non Hispanic White Beneficiaries |
78 |
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 |
73 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.0122 |