National Provider Identifier [NPI]: |
1184674186 |
Last Name Of The Provider |
HARVEY |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5255 E STOP 11 RD |
Street Address 2 Of The Provider |
#300 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462376340 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
170 |
Number Of Medicare Beneficiaries |
107 |
Total Submitted Charge Amount |
27635 |
Total Medicare Allowed Amount |
10017.16 |
Total Medicare Payment Amount |
7691.08 |
Total Medicare Standardized Payment Amount |
9571.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
689 |
Total Drug Medicare AllowedAmount |
109.55 |
Total Drug Medicare PaymentAmount |
85.85 |
Total Drug Medicare Standardized Payment Amount |
85.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
151 |
Number Of Medicare Beneficiaries With Medical Services |
107 |
Total Medical Submitted Charge Amount |
26946 |
Total Medical Medicare Allowed Amount |
9907.61 |
Total Medical Medicare Payment Amount |
7605.23 |
Total Medical Medicare Standardized Payment Amount |
9485.31 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
39 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0668 |