National Provider Identifier [NPI]: |
1205051695 |
Last Name Of The Provider |
FRAZER |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4612 17TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941174413 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
637 |
Number Of Medicare Beneficiaries |
393 |
Total Submitted Charge Amount |
290258 |
Total Medicare Allowed Amount |
54402.67 |
Total Medicare Payment Amount |
41257.53 |
Total Medicare Standardized Payment Amount |
48019.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
637 |
Number Of Medicare Beneficiaries With Medical Services |
393 |
Total Medical Submitted Charge Amount |
290258 |
Total Medical Medicare Allowed Amount |
54402.67 |
Total Medical Medicare Payment Amount |
41257.53 |
Total Medical Medicare Standardized Payment Amount |
48019.5 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
332 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
21 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
178 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6095 |