National Provider Identifier [NPI]: |
1104804756 |
Last Name Of The Provider |
BOESIGER |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10652 S EASTERN AVE STE A |
Street Address 2 Of The Provider |
|
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890524953 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
1089 |
Number Of Medicare Beneficiaries |
379 |
Total Submitted Charge Amount |
103986 |
Total Medicare Allowed Amount |
44013.94 |
Total Medicare Payment Amount |
28716.89 |
Total Medicare Standardized Payment Amount |
34394.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
376 |
Number Of Medicare Beneficiaries With Drug Services |
78 |
Total Drug Submitted ChargeAmount |
12946 |
Total Drug Medicare AllowedAmount |
481.72 |
Total Drug Medicare PaymentAmount |
353.56 |
Total Drug Medicare Standardized Payment Amount |
353.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
713 |
Number Of Medicare Beneficiaries With Medical Services |
379 |
Total Medical Submitted Charge Amount |
91040 |
Total Medical Medicare Allowed Amount |
43532.22 |
Total Medical Medicare Payment Amount |
28363.33 |
Total Medical Medicare Standardized Payment Amount |
34040.79 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
299 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
333 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9506 |