National Provider Identifier [NPI]: |
1427048149 |
Last Name Of The Provider |
MANKEY |
First Name Of The Provider |
CELINA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
313 E 12TH ST |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787011954 |
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 |
20 |
Number Of Services |
263 |
Number Of Medicare Beneficiaries |
123 |
Total Submitted Charge Amount |
76973 |
Total Medicare Allowed Amount |
25708.67 |
Total Medicare Payment Amount |
18051.87 |
Total Medicare Standardized Payment Amount |
18275.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
13 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
2081 |
Total Drug Medicare AllowedAmount |
589.69 |
Total Drug Medicare PaymentAmount |
577.88 |
Total Drug Medicare Standardized Payment Amount |
577.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
250 |
Number Of Medicare Beneficiaries With Medical Services |
123 |
Total Medical Submitted Charge Amount |
74892 |
Total Medical Medicare Allowed Amount |
25118.98 |
Total Medical Medicare Payment Amount |
17473.99 |
Total Medical Medicare Standardized Payment Amount |
17697.33 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
83 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0595 |