National Provider Identifier [NPI]: |
1831227511 |
Last Name Of The Provider |
DAVIES |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 S UNION AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HAVRE DE GRACE |
Zip Code Of The Provider |
210783409 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
402 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
256560 |
Total Medicare Allowed Amount |
42385.68 |
Total Medicare Payment Amount |
32787.08 |
Total Medicare Standardized Payment Amount |
36792.27 |
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 |
40 |
Number Of Medical Services |
402 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
256560 |
Total Medical Medicare Allowed Amount |
42385.68 |
Total Medical Medicare Payment Amount |
32787.08 |
Total Medical Medicare Standardized Payment Amount |
36792.27 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
285 |
Number Of Black or African American Beneficiaries |
|
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6141 |