National Provider Identifier [NPI]: |
1376570440 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
537 UNION AVE |
Street Address 2 Of The Provider |
SECOND FLOOR |
City Of The Provider |
GRANTS PASS |
Zip Code Of The Provider |
975275543 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
1945 |
Number Of Medicare Beneficiaries |
732 |
Total Submitted Charge Amount |
418774 |
Total Medicare Allowed Amount |
138123.96 |
Total Medicare Payment Amount |
97811.69 |
Total Medicare Standardized Payment Amount |
121761.63 |
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 |
37 |
Number Of Medical Services |
1945 |
Number Of Medicare Beneficiaries With Medical Services |
732 |
Total Medical Submitted Charge Amount |
418774 |
Total Medical Medicare Allowed Amount |
138123.96 |
Total Medical Medicare Payment Amount |
97811.69 |
Total Medical Medicare Standardized Payment Amount |
121761.63 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
339 |
Number Of Beneficiaries Age 75 to 84 |
187 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
396 |
Number Of Male Beneficiaries |
336 |
Number Of Non Hispanic White Beneficiaries |
701 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
646 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.014 |