| National Provider Identifier [NPI]: | 1265401277 |
| Last Name Of The Provider | PACKARD |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PHYSICIAN ASSISTANT |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 221 E 10TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OGALLALA |
| Zip Code Of The Provider | 691531425 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 1663 |
| Number Of Medicare Beneficiaries | 302 |
| Total Submitted Charge Amount | 111317.08 |
| Total Medicare Allowed Amount | 58971.77 |
| Total Medicare Payment Amount | 39182.44 |
| Total Medicare Standardized Payment Amount | 51003.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 148 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 3935 |
| Total Drug Medicare AllowedAmount | 2702.86 |
| Total Drug Medicare PaymentAmount | 2551.64 |
| Total Drug Medicare Standardized Payment Amount | 2551.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 1515 |
| Number Of Medicare Beneficiaries With Medical Services | 302 |
| Total Medical Submitted Charge Amount | 107382.08 |
| Total Medical Medicare Allowed Amount | 56268.91 |
| Total Medical Medicare Payment Amount | 36630.8 |
| Total Medical Medicare Standardized Payment Amount | 48452.05 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 181 |
| Number Of Male Beneficiaries | 121 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 270 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 33 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8845 |