National Provider Identifier [NPI]: |
1326361874 |
Last Name Of The Provider |
JENKINS |
First Name Of The Provider |
BRANDIE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PHYSICIAN ASSISTANT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7254 BLANCO RD |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782164990 |
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 |
21 |
Number Of Services |
295 |
Number Of Medicare Beneficiaries |
207 |
Total Submitted Charge Amount |
182207 |
Total Medicare Allowed Amount |
23832.28 |
Total Medicare Payment Amount |
18636.42 |
Total Medicare Standardized Payment Amount |
22523.43 |
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 |
21 |
Number Of Medical Services |
295 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
182207 |
Total Medical Medicare Allowed Amount |
23832.28 |
Total Medical Medicare Payment Amount |
18636.42 |
Total Medical Medicare Standardized Payment Amount |
22523.43 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
131 |
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 |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.4914 |