National Provider Identifier [NPI]: |
1104025071 |
Last Name Of The Provider |
KALINA |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2400 N I 35 |
Street Address 2 Of The Provider |
|
City Of The Provider |
WAXAHACHIE |
Zip Code Of The Provider |
751655240 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
583 |
Number Of Medicare Beneficiaries |
395 |
Total Submitted Charge Amount |
170097 |
Total Medicare Allowed Amount |
77381.25 |
Total Medicare Payment Amount |
60123.26 |
Total Medicare Standardized Payment Amount |
60305.3 |
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 |
23 |
Number Of Medical Services |
583 |
Number Of Medicare Beneficiaries With Medical Services |
395 |
Total Medical Submitted Charge Amount |
170097 |
Total Medical Medicare Allowed Amount |
77381.25 |
Total Medical Medicare Payment Amount |
60123.26 |
Total Medical Medicare Standardized Payment Amount |
60305.3 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
147 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
217 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
221 |
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 |
183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
212 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
70 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
3.5534 |