National Provider Identifier [NPI]: |
1023180361 |
Last Name Of The Provider |
CAMERON |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
580-90 COURT STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
KEENE |
Zip Code Of The Provider |
03431 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
853 |
Number Of Medicare Beneficiaries |
403 |
Total Submitted Charge Amount |
87461.3 |
Total Medicare Allowed Amount |
41050.81 |
Total Medicare Payment Amount |
30857.02 |
Total Medicare Standardized Payment Amount |
36246.39 |
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 |
24 |
Number Of Medical Services |
853 |
Number Of Medicare Beneficiaries With Medical Services |
403 |
Total Medical Submitted Charge Amount |
87461.3 |
Total Medical Medicare Allowed Amount |
41050.81 |
Total Medical Medicare Payment Amount |
30857.02 |
Total Medical Medicare Standardized Payment Amount |
36246.39 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
334 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2128 |