National Provider Identifier [NPI]: |
1649550518 |
Last Name Of The Provider |
MCCOY |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3107 FREDERICK AVE. |
Street Address 2 Of The Provider |
ORTHOPEDIC & SPORTS MEDICINE CENTER |
City Of The Provider |
ST. JOSEPH |
Zip Code Of The Provider |
645062911 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
794 |
Number Of Medicare Beneficiaries |
622 |
Total Submitted Charge Amount |
699823 |
Total Medicare Allowed Amount |
93854.02 |
Total Medicare Payment Amount |
70221.52 |
Total Medicare Standardized Payment Amount |
88267.36 |
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 |
33 |
Number Of Medical Services |
794 |
Number Of Medicare Beneficiaries With Medical Services |
622 |
Total Medical Submitted Charge Amount |
699823 |
Total Medical Medicare Allowed Amount |
93854.02 |
Total Medical Medicare Payment Amount |
70221.52 |
Total Medical Medicare Standardized Payment Amount |
88267.36 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
195 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
360 |
Number Of Male Beneficiaries |
262 |
Number Of Non Hispanic White Beneficiaries |
595 |
Number Of Black or African American Beneficiaries |
14 |
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 |
362 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
260 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7135 |