National Provider Identifier [NPI]: |
1487907440 |
Last Name Of The Provider |
ROWLAND |
First Name Of The Provider |
SPENCER |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6635 LAKE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MORROW |
Zip Code Of The Provider |
302602354 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
1142 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
482021.2 |
Total Medicare Allowed Amount |
65338.58 |
Total Medicare Payment Amount |
47576.67 |
Total Medicare Standardized Payment Amount |
53746.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
155 |
Number Of Medicare Beneficiaries With Drug Services |
83 |
Total Drug Submitted ChargeAmount |
12517 |
Total Drug Medicare AllowedAmount |
5578.16 |
Total Drug Medicare PaymentAmount |
4149.45 |
Total Drug Medicare Standardized Payment Amount |
4149.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
987 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
469504.2 |
Total Medical Medicare Allowed Amount |
59760.42 |
Total Medical Medicare Payment Amount |
43427.22 |
Total Medical Medicare Standardized Payment Amount |
49597.01 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
193 |
Number Of Male Beneficiaries |
125 |
Number Of Non Hispanic White Beneficiaries |
217 |
Number Of Black or African American Beneficiaries |
89 |
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 |
269 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2316 |