National Provider Identifier [NPI]: |
1043488877 |
Last Name Of The Provider |
KNOX |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 E PONCE DE LEON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DECATUR |
Zip Code Of The Provider |
300303466 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
226 |
Number Of Medicare Beneficiaries |
76 |
Total Submitted Charge Amount |
24765.24 |
Total Medicare Allowed Amount |
9889.06 |
Total Medicare Payment Amount |
6648.07 |
Total Medicare Standardized Payment Amount |
7928.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
462 |
Total Drug Medicare AllowedAmount |
236.41 |
Total Drug Medicare PaymentAmount |
230.9 |
Total Drug Medicare Standardized Payment Amount |
230.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
209 |
Number Of Medicare Beneficiaries With Medical Services |
76 |
Total Medical Submitted Charge Amount |
24303.24 |
Total Medical Medicare Allowed Amount |
9652.65 |
Total Medical Medicare Payment Amount |
6417.17 |
Total Medical Medicare Standardized Payment Amount |
7697.14 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
17 |
Number Of Non Hispanic White Beneficiaries |
52 |
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 |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7614 |