National Provider Identifier [NPI]: |
1144330366 |
Last Name Of The Provider |
HANSON |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
450 S WILLARD ST |
Street Address 2 Of The Provider |
STE 103 |
City Of The Provider |
COTTONWOOD |
Zip Code Of The Provider |
86326 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
3545 |
Number Of Medicare Beneficiaries |
484 |
Total Submitted Charge Amount |
559442.46 |
Total Medicare Allowed Amount |
275452.72 |
Total Medicare Payment Amount |
197653.98 |
Total Medicare Standardized Payment Amount |
197058.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
356 |
Number Of Medicare Beneficiaries With Drug Services |
224 |
Total Drug Submitted ChargeAmount |
10052 |
Total Drug Medicare AllowedAmount |
3500.13 |
Total Drug Medicare PaymentAmount |
3320.64 |
Total Drug Medicare Standardized Payment Amount |
3320.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
3189 |
Number Of Medicare Beneficiaries With Medical Services |
484 |
Total Medical Submitted Charge Amount |
549390.46 |
Total Medical Medicare Allowed Amount |
271952.59 |
Total Medical Medicare Payment Amount |
194333.34 |
Total Medical Medicare Standardized Payment Amount |
193738.07 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
173 |
Number Of Beneficiaries Age 75 to 84 |
177 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
238 |
Number Of Non Hispanic White Beneficiaries |
463 |
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 |
472 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2488 |