National Provider Identifier [NPI]: |
1922234384 |
Last Name Of The Provider |
BACOT |
First Name Of The Provider |
ISABELL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3705 MEDICAL PKWY |
Street Address 2 Of The Provider |
250 |
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787051019 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
942 |
Number Of Medicare Beneficiaries |
296 |
Total Submitted Charge Amount |
151352.19 |
Total Medicare Allowed Amount |
108984.39 |
Total Medicare Payment Amount |
80946.28 |
Total Medicare Standardized Payment Amount |
98809.49 |
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 |
10 |
Number Of Medical Services |
942 |
Number Of Medicare Beneficiaries With Medical Services |
296 |
Total Medical Submitted Charge Amount |
151352.19 |
Total Medical Medicare Allowed Amount |
108984.39 |
Total Medical Medicare Payment Amount |
80946.28 |
Total Medical Medicare Standardized Payment Amount |
98809.49 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
168 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
73 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.3662 |