National Provider Identifier [NPI]: |
1235302753 |
Last Name Of The Provider |
WOOD |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
240 SHERATON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MACON |
Zip Code Of The Provider |
312101358 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
388 |
Number Of Medicare Beneficiaries |
360 |
Total Submitted Charge Amount |
372302 |
Total Medicare Allowed Amount |
37510.73 |
Total Medicare Payment Amount |
28604.42 |
Total Medicare Standardized Payment Amount |
34509.89 |
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 |
12 |
Number Of Medical Services |
388 |
Number Of Medicare Beneficiaries With Medical Services |
360 |
Total Medical Submitted Charge Amount |
372302 |
Total Medical Medicare Allowed Amount |
37510.73 |
Total Medical Medicare Payment Amount |
28604.42 |
Total Medical Medicare Standardized Payment Amount |
34509.89 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
165 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
142 |
Number Of Non Hispanic White Beneficiaries |
205 |
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 |
196 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7176 |