National Provider Identifier [NPI]: |
1336236744 |
Last Name Of The Provider |
WRIGHT |
First Name Of The Provider |
TATYANA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
870 S FRONT ST |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
CENTRAL POINT |
Zip Code Of The Provider |
975022779 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
403 |
Number Of Medicare Beneficiaries |
260 |
Total Submitted Charge Amount |
104394.86 |
Total Medicare Allowed Amount |
24260.55 |
Total Medicare Payment Amount |
17622.14 |
Total Medicare Standardized Payment Amount |
21617.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
775 |
Total Drug Medicare AllowedAmount |
481.33 |
Total Drug Medicare PaymentAmount |
464.28 |
Total Drug Medicare Standardized Payment Amount |
464.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
364 |
Number Of Medicare Beneficiaries With Medical Services |
260 |
Total Medical Submitted Charge Amount |
103619.86 |
Total Medical Medicare Allowed Amount |
23779.22 |
Total Medical Medicare Payment Amount |
17157.86 |
Total Medical Medicare Standardized Payment Amount |
21153.35 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
245 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
192 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9901 |