National Provider Identifier [NPI]: |
1962537852 |
Last Name Of The Provider |
ADAMS |
First Name Of The Provider |
JARED |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6121 N THESTA ST |
Street Address 2 Of The Provider |
STE. 114 |
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937108603 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
875 |
Number Of Medicare Beneficiaries |
316 |
Total Submitted Charge Amount |
302843 |
Total Medicare Allowed Amount |
80083 |
Total Medicare Payment Amount |
61711.3 |
Total Medicare Standardized Payment Amount |
62120.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
280 |
Number Of Medicare Beneficiaries With Drug Services |
127 |
Total Drug Submitted ChargeAmount |
134470 |
Total Drug Medicare AllowedAmount |
42694.65 |
Total Drug Medicare PaymentAmount |
33268.18 |
Total Drug Medicare Standardized Payment Amount |
33268.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
595 |
Number Of Medicare Beneficiaries With Medical Services |
316 |
Total Medical Submitted Charge Amount |
168373 |
Total Medical Medicare Allowed Amount |
37388.35 |
Total Medical Medicare Payment Amount |
28443.12 |
Total Medical Medicare Standardized Payment Amount |
28852.02 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
193 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
245 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
15 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7721 |