National Provider Identifier [NPI]: |
1396908950 |
Last Name Of The Provider |
SOLIS |
First Name Of The Provider |
DENISE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7323 MARBACH RD |
Street Address 2 Of The Provider |
SUITE 104 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782271907 |
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 |
57 |
Number Of Services |
1273 |
Number Of Medicare Beneficiaries |
223 |
Total Submitted Charge Amount |
69742.18 |
Total Medicare Allowed Amount |
31971.34 |
Total Medicare Payment Amount |
18431.02 |
Total Medicare Standardized Payment Amount |
24488.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
359 |
Number Of Medicare Beneficiaries With Drug Services |
67 |
Total Drug Submitted ChargeAmount |
6846.18 |
Total Drug Medicare AllowedAmount |
1270.58 |
Total Drug Medicare PaymentAmount |
827.82 |
Total Drug Medicare Standardized Payment Amount |
827.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
914 |
Number Of Medicare Beneficiaries With Medical Services |
223 |
Total Medical Submitted Charge Amount |
62896 |
Total Medical Medicare Allowed Amount |
30700.76 |
Total Medical Medicare Payment Amount |
17603.2 |
Total Medical Medicare Standardized Payment Amount |
23660.36 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
75 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
108 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
121 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0215 |