National Provider Identifier [NPI]: |
1275506719 |
Last Name Of The Provider |
SCHULTZ |
First Name Of The Provider |
HEIDI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29818 FM 1093 |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
FULSHEAR |
Zip Code Of The Provider |
77441 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
2167 |
Number Of Medicare Beneficiaries |
448 |
Total Submitted Charge Amount |
158148.78 |
Total Medicare Allowed Amount |
110650.85 |
Total Medicare Payment Amount |
76120.28 |
Total Medicare Standardized Payment Amount |
82517.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
449 |
Number Of Medicare Beneficiaries With Drug Services |
105 |
Total Drug Submitted ChargeAmount |
8892 |
Total Drug Medicare AllowedAmount |
2889.42 |
Total Drug Medicare PaymentAmount |
2562.29 |
Total Drug Medicare Standardized Payment Amount |
2562.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
1718 |
Number Of Medicare Beneficiaries With Medical Services |
448 |
Total Medical Submitted Charge Amount |
149256.78 |
Total Medical Medicare Allowed Amount |
107761.43 |
Total Medical Medicare Payment Amount |
73557.99 |
Total Medical Medicare Standardized Payment Amount |
79955.69 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
276 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
298 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
411 |
Number Of Black or African American Beneficiaries |
15 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8942 |