National Provider Identifier [NPI]: |
1851493134 |
Last Name Of The Provider |
JANKE |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
205 PLATT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MERRITT ISLAND |
Zip Code Of The Provider |
329524963 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
268 |
Number Of Medicare Beneficiaries |
184 |
Total Submitted Charge Amount |
563320 |
Total Medicare Allowed Amount |
36879.56 |
Total Medicare Payment Amount |
28913.32 |
Total Medicare Standardized Payment Amount |
27979.32 |
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 |
82 |
Number Of Medical Services |
268 |
Number Of Medicare Beneficiaries With Medical Services |
184 |
Total Medical Submitted Charge Amount |
563320 |
Total Medical Medicare Allowed Amount |
36879.56 |
Total Medical Medicare Payment Amount |
28913.32 |
Total Medical Medicare Standardized Payment Amount |
27979.32 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
167 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
156 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3423 |