National Provider Identifier [NPI]: |
1194952747 |
Last Name Of The Provider |
RICHMAN |
First Name Of The Provider |
CARMEN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
611 W FRANCIS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTH PLATTE |
Zip Code Of The Provider |
691010614 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
502 |
Number Of Medicare Beneficiaries |
145 |
Total Submitted Charge Amount |
43016 |
Total Medicare Allowed Amount |
21761.33 |
Total Medicare Payment Amount |
15287.91 |
Total Medicare Standardized Payment Amount |
19794.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
238 |
Total Drug Medicare AllowedAmount |
163.19 |
Total Drug Medicare PaymentAmount |
153.05 |
Total Drug Medicare Standardized Payment Amount |
153.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
479 |
Number Of Medicare Beneficiaries With Medical Services |
145 |
Total Medical Submitted Charge Amount |
42778 |
Total Medical Medicare Allowed Amount |
21598.14 |
Total Medical Medicare Payment Amount |
15134.86 |
Total Medical Medicare Standardized Payment Amount |
19641.28 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
134 |
Number Of Black or African American Beneficiaries |
0 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0089 |