National Provider Identifier [NPI]: |
1073645883 |
Last Name Of The Provider |
JAMES |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3401 ENTERPRISE PKWY |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
BEACHWOOD |
Zip Code Of The Provider |
441227341 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
165 |
Number Of Medicare Beneficiaries |
156 |
Total Submitted Charge Amount |
49500 |
Total Medicare Allowed Amount |
32591.04 |
Total Medicare Payment Amount |
25334.58 |
Total Medicare Standardized Payment Amount |
26318.74 |
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 |
7 |
Number Of Medical Services |
165 |
Number Of Medicare Beneficiaries With Medical Services |
156 |
Total Medical Submitted Charge Amount |
49500 |
Total Medical Medicare Allowed Amount |
32591.04 |
Total Medical Medicare Payment Amount |
25334.58 |
Total Medical Medicare Standardized Payment Amount |
26318.74 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
78 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
130 |
Number Of Black or African American Beneficiaries |
12 |
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.346 |