National Provider Identifier [NPI]: |
1215938923 |
Last Name Of The Provider |
WARREN |
First Name Of The Provider |
FRANK |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1015 N. HIGHLAND |
Street Address 2 Of The Provider |
|
City Of The Provider |
MURFREESBORO |
Zip Code Of The Provider |
37130 |
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 |
37 |
Number Of Services |
1216 |
Number Of Medicare Beneficiaries |
243 |
Total Submitted Charge Amount |
89871.25 |
Total Medicare Allowed Amount |
38521.82 |
Total Medicare Payment Amount |
24969.45 |
Total Medicare Standardized Payment Amount |
32806.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
452 |
Number Of Medicare Beneficiaries With Drug Services |
89 |
Total Drug Submitted ChargeAmount |
6475.25 |
Total Drug Medicare AllowedAmount |
1135.29 |
Total Drug Medicare PaymentAmount |
881.46 |
Total Drug Medicare Standardized Payment Amount |
881.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
764 |
Number Of Medicare Beneficiaries With Medical Services |
243 |
Total Medical Submitted Charge Amount |
83396 |
Total Medical Medicare Allowed Amount |
37386.53 |
Total Medical Medicare Payment Amount |
24087.99 |
Total Medical Medicare Standardized Payment Amount |
31924.87 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
225 |
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 |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1454 |