National Provider Identifier [NPI]: |
1891003265 |
Last Name Of The Provider |
AARDEMA |
First Name Of The Provider |
CRITT |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4403 HARRISON BLVD |
Street Address 2 Of The Provider |
SUITE A-700 |
City Of The Provider |
OGDEN |
Zip Code Of The Provider |
844033271 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
113 |
Number Of Services |
1288 |
Number Of Medicare Beneficiaries |
205 |
Total Submitted Charge Amount |
75292.5 |
Total Medicare Allowed Amount |
46487.47 |
Total Medicare Payment Amount |
35472.65 |
Total Medicare Standardized Payment Amount |
37124.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
141 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
2279.5 |
Total Drug Medicare AllowedAmount |
1845.02 |
Total Drug Medicare PaymentAmount |
1727.66 |
Total Drug Medicare Standardized Payment Amount |
1727.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
100 |
Number Of Medical Services |
1147 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
73013 |
Total Medical Medicare Allowed Amount |
44642.45 |
Total Medical Medicare Payment Amount |
33744.99 |
Total Medical Medicare Standardized Payment Amount |
35397.28 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
77 |
Number Of Non Hispanic White Beneficiaries |
179 |
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 |
182 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8799 |