National Provider Identifier [NPI]: |
1235165184 |
Last Name Of The Provider |
WEBER-MCREYNOLDS |
First Name Of The Provider |
HELEN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9650 E WASHINGTON ST |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462293032 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
545 |
Number Of Medicare Beneficiaries |
341 |
Total Submitted Charge Amount |
114234 |
Total Medicare Allowed Amount |
34440.94 |
Total Medicare Payment Amount |
23096.82 |
Total Medicare Standardized Payment Amount |
30112.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
11 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
285 |
Total Drug Medicare AllowedAmount |
171.03 |
Total Drug Medicare PaymentAmount |
167.03 |
Total Drug Medicare Standardized Payment Amount |
167.03 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
534 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
113949 |
Total Medical Medicare Allowed Amount |
34269.91 |
Total Medical Medicare Payment Amount |
22929.79 |
Total Medical Medicare Standardized Payment Amount |
29945.41 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
234 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
200 |
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 |
217 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1681 |