National Provider Identifier [NPI]: |
1659452373 |
Last Name Of The Provider |
ROXAS |
First Name Of The Provider |
CARMELO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10701 EAST BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
441061702 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
72 |
Number Of Medicare Beneficiaries |
70 |
Total Submitted Charge Amount |
10210 |
Total Medicare Allowed Amount |
7654.18 |
Total Medicare Payment Amount |
6000.98 |
Total Medicare Standardized Payment Amount |
6997.57 |
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 |
13 |
Number Of Medical Services |
72 |
Number Of Medicare Beneficiaries With Medical Services |
70 |
Total Medical Submitted Charge Amount |
10210 |
Total Medical Medicare Allowed Amount |
7654.18 |
Total Medical Medicare Payment Amount |
6000.98 |
Total Medical Medicare Standardized Payment Amount |
6997.57 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.0483 |