National Provider Identifier [NPI]: |
1023227717 |
Last Name Of The Provider |
JANTZ |
First Name Of The Provider |
CANDICE |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6130 W PARKER RD |
Street Address 2 Of The Provider |
SUITE 310 |
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750937901 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
737 |
Number Of Medicare Beneficiaries |
232 |
Total Submitted Charge Amount |
307389 |
Total Medicare Allowed Amount |
76690.19 |
Total Medicare Payment Amount |
56649.44 |
Total Medicare Standardized Payment Amount |
60840.52 |
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 |
35 |
Number Of Medical Services |
737 |
Number Of Medicare Beneficiaries With Medical Services |
232 |
Total Medical Submitted Charge Amount |
307389 |
Total Medical Medicare Allowed Amount |
76690.19 |
Total Medical Medicare Payment Amount |
56649.44 |
Total Medical Medicare Standardized Payment Amount |
60840.52 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
160 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
195 |
Number Of Black or African American Beneficiaries |
14 |
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 |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5353 |