| National Provider Identifier [NPI]: | 1366779134 |
| Last Name Of The Provider | SHACKELFORD |
| First Name Of The Provider | ANNE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 220 WESLEY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | KERRVILLE |
| Zip Code Of The Provider | 780285809 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 3415.6 |
| Number Of Medicare Beneficiaries | 520 |
| Total Submitted Charge Amount | 190285.72 |
| Total Medicare Allowed Amount | 139702.07 |
| Total Medicare Payment Amount | 104754.4 |
| Total Medicare Standardized Payment Amount | 129644.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 304.6 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 17668.5 |
| Total Drug Medicare AllowedAmount | 6994.12 |
| Total Drug Medicare PaymentAmount | 6620.53 |
| Total Drug Medicare Standardized Payment Amount | 6620.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 3111 |
| Number Of Medicare Beneficiaries With Medical Services | 520 |
| Total Medical Submitted Charge Amount | 172617.22 |
| Total Medical Medicare Allowed Amount | 132707.95 |
| Total Medical Medicare Payment Amount | 98133.87 |
| Total Medical Medicare Standardized Payment Amount | 123024.35 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 125 |
| Number Of Female Beneficiaries | 363 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | 465 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 413 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.295 |