National Provider Identifier [NPI]: |
1326049933 |
Last Name Of The Provider |
EVANS |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5301 E GRANT RD |
Street Address 2 Of The Provider |
ORTHOPAEDIC BUILDING, 1ST FLOOR |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857122805 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1335 |
Number Of Medicare Beneficiaries |
369 |
Total Submitted Charge Amount |
179120 |
Total Medicare Allowed Amount |
61022.69 |
Total Medicare Payment Amount |
43584.33 |
Total Medicare Standardized Payment Amount |
44461.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
105 |
Number Of Medicare Beneficiaries With Drug Services |
54 |
Total Drug Submitted ChargeAmount |
724 |
Total Drug Medicare AllowedAmount |
130.24 |
Total Drug Medicare PaymentAmount |
95.2 |
Total Drug Medicare Standardized Payment Amount |
95.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
1230 |
Number Of Medicare Beneficiaries With Medical Services |
369 |
Total Medical Submitted Charge Amount |
178396 |
Total Medical Medicare Allowed Amount |
60892.45 |
Total Medical Medicare Payment Amount |
43489.13 |
Total Medical Medicare Standardized Payment Amount |
44366.32 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
173 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
321 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
344 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0366 |