National Provider Identifier [NPI]: |
1538330220 |
Last Name Of The Provider |
JUSTUS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEARCY |
Zip Code Of The Provider |
721434802 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
314 |
Number Of Medicare Beneficiaries |
234 |
Total Submitted Charge Amount |
132249 |
Total Medicare Allowed Amount |
21617.17 |
Total Medicare Payment Amount |
16093.89 |
Total Medicare Standardized Payment Amount |
20220.3 |
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 |
14 |
Number Of Medical Services |
314 |
Number Of Medicare Beneficiaries With Medical Services |
234 |
Total Medical Submitted Charge Amount |
132249 |
Total Medical Medicare Allowed Amount |
21617.17 |
Total Medical Medicare Payment Amount |
16093.89 |
Total Medical Medicare Standardized Payment Amount |
20220.3 |
Average Age Of Beneficiaries |
50 |
Number Of Beneficiaries Age Less65 |
196 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1169 |