National Provider Identifier [NPI]: |
1487781977 |
Last Name Of The Provider |
GAMBLE |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
421 W CHEW ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALLENTOWN |
Zip Code Of The Provider |
181023406 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
231 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
45835 |
Total Medicare Allowed Amount |
18994.27 |
Total Medicare Payment Amount |
13435.72 |
Total Medicare Standardized Payment Amount |
16378.29 |
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 |
10 |
Number Of Medical Services |
231 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
45835 |
Total Medical Medicare Allowed Amount |
18994.27 |
Total Medical Medicare Payment Amount |
13435.72 |
Total Medical Medicare Standardized Payment Amount |
16378.29 |
Average Age Of Beneficiaries |
54 |
Number Of Beneficiaries Age Less65 |
133 |
Number Of Beneficiaries Age 65 to 74 |
28 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
79 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
76 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
47 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
21 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0892 |