National Provider Identifier [NPI]: |
1194734954 |
Last Name Of The Provider |
PALACIOS |
First Name Of The Provider |
RAFAEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PHYSICIAN ASSISTANT |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1431 SW 1ST AVE |
Street Address 2 Of The Provider |
OCALA REGIONAL MEDICAL CENTER, DPMT OF EMERGENCY MED |
City Of The Provider |
OCALA |
Zip Code Of The Provider |
34471 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
572 |
Number Of Medicare Beneficiaries |
410 |
Total Submitted Charge Amount |
408453 |
Total Medicare Allowed Amount |
48159.95 |
Total Medicare Payment Amount |
36180.58 |
Total Medicare Standardized Payment Amount |
41989.87 |
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 |
21 |
Number Of Medical Services |
572 |
Number Of Medicare Beneficiaries With Medical Services |
410 |
Total Medical Submitted Charge Amount |
408453 |
Total Medical Medicare Allowed Amount |
48159.95 |
Total Medical Medicare Payment Amount |
36180.58 |
Total Medical Medicare Standardized Payment Amount |
41989.87 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
327 |
Number Of Black or African American Beneficiaries |
41 |
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 |
289 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8127 |