National Provider Identifier [NPI]: |
1790776276 |
Last Name Of The Provider |
SUTTON |
First Name Of The Provider |
JENNEFER |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4118 POND HILL RD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
SHAVANO PARK |
Zip Code Of The Provider |
782311281 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
554 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
105859.77 |
Total Medicare Allowed Amount |
34557.54 |
Total Medicare Payment Amount |
23516.33 |
Total Medicare Standardized Payment Amount |
25891.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
42 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
2093 |
Total Drug Medicare AllowedAmount |
872.6 |
Total Drug Medicare PaymentAmount |
843.49 |
Total Drug Medicare Standardized Payment Amount |
843.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
512 |
Number Of Medicare Beneficiaries With Medical Services |
124 |
Total Medical Submitted Charge Amount |
103766.77 |
Total Medical Medicare Allowed Amount |
33684.94 |
Total Medical Medicare Payment Amount |
22672.84 |
Total Medical Medicare Standardized Payment Amount |
25047.84 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
102 |
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 |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7022 |