| National Provider Identifier [NPI]: | 1346217163 |
| Last Name Of The Provider | JENEVEIN |
| First Name Of The Provider | NOLAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6301 GASTON AVE |
| Street Address 2 Of The Provider | SUITE 100 WEST TOWER |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752143922 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 10685 |
| Number Of Medicare Beneficiaries | 1112 |
| Total Submitted Charge Amount | 968232.27 |
| Total Medicare Allowed Amount | 510123.34 |
| Total Medicare Payment Amount | 385720.57 |
| Total Medicare Standardized Payment Amount | 387879.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 6391 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 77065 |
| Total Drug Medicare AllowedAmount | 66907.97 |
| Total Drug Medicare PaymentAmount | 52351.65 |
| Total Drug Medicare Standardized Payment Amount | 52351.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 4294 |
| Number Of Medicare Beneficiaries With Medical Services | 1112 |
| Total Medical Submitted Charge Amount | 891167.27 |
| Total Medical Medicare Allowed Amount | 443215.37 |
| Total Medical Medicare Payment Amount | 333368.92 |
| Total Medical Medicare Standardized Payment Amount | 335528.08 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 294 |
| Number Of Beneficiaries Age 65 to 74 | 481 |
| Number Of Beneficiaries Age 75 to 84 | 255 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 639 |
| Number Of Male Beneficiaries | 473 |
| Number Of Non Hispanic White Beneficiaries | 820 |
| Number Of Black or African American Beneficiaries | 199 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 841 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 271 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 1.7296 |