National Provider Identifier [NPI]: |
1841599503 |
Last Name Of The Provider |
ROWTHER |
First Name Of The Provider |
SOFIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1300 W TERRELL AVE STE 500 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761042810 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
524 |
Number Of Medicare Beneficiaries |
387 |
Total Submitted Charge Amount |
92361 |
Total Medicare Allowed Amount |
38111.29 |
Total Medicare Payment Amount |
28636.23 |
Total Medicare Standardized Payment Amount |
34635.77 |
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 |
8 |
Number Of Medical Services |
524 |
Number Of Medicare Beneficiaries With Medical Services |
387 |
Total Medical Submitted Charge Amount |
92361 |
Total Medical Medicare Allowed Amount |
38111.29 |
Total Medical Medicare Payment Amount |
28636.23 |
Total Medical Medicare Standardized Payment Amount |
34635.77 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
137 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
194 |
Number Of Male Beneficiaries |
193 |
Number Of Non Hispanic White Beneficiaries |
344 |
Number Of Black or African American Beneficiaries |
21 |
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 |
352 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5998 |