National Provider Identifier [NPI]: |
1114153301 |
Last Name Of The Provider |
BACKLUND |
First Name Of The Provider |
AMANDA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7601 QUAKER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUBBOCK |
Zip Code Of The Provider |
794243360 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
3016 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
223081.02 |
Total Medicare Allowed Amount |
93741.6 |
Total Medicare Payment Amount |
69042.67 |
Total Medicare Standardized Payment Amount |
74174.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
431 |
Number Of Medicare Beneficiaries With Drug Services |
119 |
Total Drug Submitted ChargeAmount |
10105.02 |
Total Drug Medicare AllowedAmount |
2743 |
Total Drug Medicare PaymentAmount |
2552.23 |
Total Drug Medicare Standardized Payment Amount |
2552.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
79 |
Number Of Medical Services |
2585 |
Number Of Medicare Beneficiaries With Medical Services |
287 |
Total Medical Submitted Charge Amount |
212976 |
Total Medical Medicare Allowed Amount |
90998.6 |
Total Medical Medicare Payment Amount |
66490.44 |
Total Medical Medicare Standardized Payment Amount |
71621.86 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
77 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.113 |