National Provider Identifier [NPI]: |
1427036136 |
Last Name Of The Provider |
ANGSTADT |
First Name Of The Provider |
YOLANDA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4755 OGLETOWN-STANTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
19718 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
243 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
74884 |
Total Medicare Allowed Amount |
18501.44 |
Total Medicare Payment Amount |
14071.96 |
Total Medicare Standardized Payment Amount |
16614.52 |
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 |
14 |
Number Of Medical Services |
243 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
74884 |
Total Medical Medicare Allowed Amount |
18501.44 |
Total Medical Medicare Payment Amount |
14071.96 |
Total Medical Medicare Standardized Payment Amount |
16614.52 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
90 |
Number Of Black or African American Beneficiaries |
100 |
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 |
86 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7472 |