National Provider Identifier [NPI]: |
1689805400 |
Last Name Of The Provider |
OSEDO |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5959 PARK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381195200 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
617 |
Number Of Medicare Beneficiaries |
518 |
Total Submitted Charge Amount |
607989 |
Total Medicare Allowed Amount |
59979.23 |
Total Medicare Payment Amount |
45671.54 |
Total Medicare Standardized Payment Amount |
55272.41 |
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 |
22 |
Number Of Medical Services |
617 |
Number Of Medicare Beneficiaries With Medical Services |
518 |
Total Medical Submitted Charge Amount |
607989 |
Total Medical Medicare Allowed Amount |
59979.23 |
Total Medical Medicare Payment Amount |
45671.54 |
Total Medical Medicare Standardized Payment Amount |
55272.41 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
261 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
233 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
268 |
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 |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
274 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.9784 |