National Provider Identifier [NPI]: |
1104122746 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
JOSHUA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
291 N PECOS RD |
Street Address 2 Of The Provider |
FAMILY DOCTORS OF GREEN VALLEY |
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890741918 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
918 |
Number Of Medicare Beneficiaries |
143 |
Total Submitted Charge Amount |
145087.5 |
Total Medicare Allowed Amount |
45532.32 |
Total Medicare Payment Amount |
30510.95 |
Total Medicare Standardized Payment Amount |
36470.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
115 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
3862.5 |
Total Drug Medicare AllowedAmount |
427.4 |
Total Drug Medicare PaymentAmount |
356.83 |
Total Drug Medicare Standardized Payment Amount |
356.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
803 |
Number Of Medicare Beneficiaries With Medical Services |
143 |
Total Medical Submitted Charge Amount |
141225 |
Total Medical Medicare Allowed Amount |
45104.92 |
Total Medical Medicare Payment Amount |
30154.12 |
Total Medical Medicare Standardized Payment Amount |
36113.7 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
102 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
112 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1449 |