National Provider Identifier [NPI]: |
1265472880 |
Last Name Of The Provider |
SPROLES |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
P.A.-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 E DAWSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757012036 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
385 |
Number Of Medicare Beneficiaries |
288 |
Total Submitted Charge Amount |
220790 |
Total Medicare Allowed Amount |
32543.92 |
Total Medicare Payment Amount |
25089.91 |
Total Medicare Standardized Payment Amount |
30461.36 |
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 |
15 |
Number Of Medical Services |
385 |
Number Of Medicare Beneficiaries With Medical Services |
288 |
Total Medical Submitted Charge Amount |
220790 |
Total Medical Medicare Allowed Amount |
32543.92 |
Total Medical Medicare Payment Amount |
25089.91 |
Total Medical Medicare Standardized Payment Amount |
30461.36 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
204 |
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 |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.4489 |