National Provider Identifier [NPI]: |
1558671263 |
Last Name Of The Provider |
DOBIES |
First Name Of The Provider |
AUTUMN |
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 |
4400 S SAGINAW ST |
Street Address 2 Of The Provider |
SUITE 1400 |
City Of The Provider |
FLINT |
Zip Code Of The Provider |
485072645 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
579 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
32415 |
Total Medicare Allowed Amount |
20255.06 |
Total Medicare Payment Amount |
15841.87 |
Total Medicare Standardized Payment Amount |
18895.39 |
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 |
4 |
Number Of Medical Services |
579 |
Number Of Medicare Beneficiaries With Medical Services |
128 |
Total Medical Submitted Charge Amount |
32415 |
Total Medical Medicare Allowed Amount |
20255.06 |
Total Medical Medicare Payment Amount |
15841.87 |
Total Medical Medicare Standardized Payment Amount |
18895.39 |
Average Age Of Beneficiaries |
50 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
12 |
Number Of Beneficiaries Age 75 to 84 |
0 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
58 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
73 |
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 |
22 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
26 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
75 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4824 |