National Provider Identifier [NPI]: |
1043514433 |
Last Name Of The Provider |
PERRY |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2020 PALOMINO LN |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891064894 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
601 |
Number Of Medicare Beneficiaries |
177 |
Total Submitted Charge Amount |
556522.91 |
Total Medicare Allowed Amount |
154787.1 |
Total Medicare Payment Amount |
117976.38 |
Total Medicare Standardized Payment Amount |
136890.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
151 |
Number Of Medicare Beneficiaries With Drug Services |
126 |
Total Drug Submitted ChargeAmount |
308.02 |
Total Drug Medicare AllowedAmount |
86.49 |
Total Drug Medicare PaymentAmount |
66.65 |
Total Drug Medicare Standardized Payment Amount |
66.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
450 |
Number Of Medicare Beneficiaries With Medical Services |
174 |
Total Medical Submitted Charge Amount |
556214.89 |
Total Medical Medicare Allowed Amount |
154700.61 |
Total Medical Medicare Payment Amount |
117909.73 |
Total Medical Medicare Standardized Payment Amount |
136823.69 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
123 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
153 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
54 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5314 |