| National Provider Identifier [NPI]: | 1962400895 |
| Last Name Of The Provider | SCHAFFNER |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4301 COLLEGE DR |
| Street Address 2 Of The Provider | SUITE # 300 |
| City Of The Provider | VERNON |
| Zip Code Of The Provider | 763843128 |
| 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 | 58 |
| Number Of Services | 2404 |
| Number Of Medicare Beneficiaries | 266 |
| Total Submitted Charge Amount | 215813.68 |
| Total Medicare Allowed Amount | 132603.43 |
| Total Medicare Payment Amount | 91434.71 |
| Total Medicare Standardized Payment Amount | 97795.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 366 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 12150.68 |
| Total Drug Medicare AllowedAmount | 4975.06 |
| Total Drug Medicare PaymentAmount | 4575.23 |
| Total Drug Medicare Standardized Payment Amount | 4575.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 2038 |
| Number Of Medicare Beneficiaries With Medical Services | 266 |
| Total Medical Submitted Charge Amount | 203663 |
| Total Medical Medicare Allowed Amount | 127628.37 |
| Total Medical Medicare Payment Amount | 86859.48 |
| Total Medical Medicare Standardized Payment Amount | 93220.05 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 236 |
| Number Of Black or African American Beneficiaries | |
| 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 | 227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2018 |