National Provider Identifier [NPI]: |
1144508151 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
ERINN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
1008 RCP |
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421007 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
141 |
Number Of Medicare Beneficiaries |
131 |
Total Submitted Charge Amount |
74938.2 |
Total Medicare Allowed Amount |
13856.06 |
Total Medicare Payment Amount |
10105.87 |
Total Medicare Standardized Payment Amount |
12849.5 |
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 |
15 |
Number Of Medical Services |
141 |
Number Of Medicare Beneficiaries With Medical Services |
131 |
Total Medical Submitted Charge Amount |
74938.2 |
Total Medical Medicare Allowed Amount |
13856.06 |
Total Medical Medicare Payment Amount |
10105.87 |
Total Medical Medicare Standardized Payment Amount |
12849.5 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
116 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5184 |