National Provider Identifier [NPI]: |
1508976846 |
Last Name Of The Provider |
MATEJA |
First Name Of The Provider |
JASON |
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 |
2727 W MLK JR BLVD |
Street Address 2 Of The Provider |
SUITE 450 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336076002 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1668 |
Number Of Medicare Beneficiaries |
389 |
Total Submitted Charge Amount |
121063.59 |
Total Medicare Allowed Amount |
56455.54 |
Total Medicare Payment Amount |
40963.13 |
Total Medicare Standardized Payment Amount |
47426.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
50 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
1970 |
Total Drug Medicare AllowedAmount |
1554.36 |
Total Drug Medicare PaymentAmount |
1523.1 |
Total Drug Medicare Standardized Payment Amount |
1523.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
1618 |
Number Of Medicare Beneficiaries With Medical Services |
389 |
Total Medical Submitted Charge Amount |
119093.59 |
Total Medical Medicare Allowed Amount |
54901.18 |
Total Medical Medicare Payment Amount |
39440.03 |
Total Medical Medicare Standardized Payment Amount |
45903.59 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
162 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
261 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
96 |
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 |
15 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1343 |