National Provider Identifier [NPI]: |
1619250826 |
Last Name Of The Provider |
RIEKS |
First Name Of The Provider |
SHELBY |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1313 RED RIVER ST |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787011943 |
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 |
38 |
Number Of Services |
140 |
Number Of Medicare Beneficiaries |
93 |
Total Submitted Charge Amount |
146238 |
Total Medicare Allowed Amount |
13794.66 |
Total Medicare Payment Amount |
10793.16 |
Total Medicare Standardized Payment Amount |
12289.63 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
71 |
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 |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
24 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7389 |