National Provider Identifier [NPI]: |
1952501447 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
LILLIAN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2601 CORNERSTONE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDINBURG |
Zip Code Of The Provider |
785398479 |
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 |
116 |
Number Of Services |
27995 |
Number Of Medicare Beneficiaries |
1098 |
Total Submitted Charge Amount |
1620867.62 |
Total Medicare Allowed Amount |
638105.86 |
Total Medicare Payment Amount |
505635.56 |
Total Medicare Standardized Payment Amount |
603268.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
20 |
Number Of Drug Services |
8683 |
Number Of Medicare Beneficiaries With Drug Services |
848 |
Total Drug Submitted ChargeAmount |
77813.62 |
Total Drug Medicare AllowedAmount |
36821.93 |
Total Drug Medicare PaymentAmount |
28532.59 |
Total Drug Medicare Standardized Payment Amount |
28532.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
96 |
Number Of Medical Services |
19312 |
Number Of Medicare Beneficiaries With Medical Services |
1098 |
Total Medical Submitted Charge Amount |
1543054 |
Total Medical Medicare Allowed Amount |
601283.93 |
Total Medical Medicare Payment Amount |
477102.97 |
Total Medical Medicare Standardized Payment Amount |
574735.43 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
356 |
Number Of Beneficiaries Age 65 to 74 |
367 |
Number Of Beneficiaries Age 75 to 84 |
317 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
872 |
Number Of Male Beneficiaries |
226 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
1013 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
202 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
896 |
Percent Of With Atrial Fibrillation |
2 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
3 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
75 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.4919 |