| National Provider Identifier [NPI]: | 1154568038 |
| Last Name Of The Provider | PRICE |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6750 N MACARTHUR BLVD |
| Street Address 2 Of The Provider | BLDG. 2, SUITE 350 |
| City Of The Provider | IRVING |
| Zip Code Of The Provider | 750392875 |
| 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 | 67 |
| Number Of Services | 2269 |
| Number Of Medicare Beneficiaries | 578 |
| Total Submitted Charge Amount | 161416 |
| Total Medicare Allowed Amount | 78312.53 |
| Total Medicare Payment Amount | 56134.94 |
| Total Medicare Standardized Payment Amount | 67406.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 109 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 3669 |
| Total Drug Medicare AllowedAmount | 2049.02 |
| Total Drug Medicare PaymentAmount | 1907.45 |
| Total Drug Medicare Standardized Payment Amount | 1907.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 2160 |
| Number Of Medicare Beneficiaries With Medical Services | 577 |
| Total Medical Submitted Charge Amount | 157747 |
| Total Medical Medicare Allowed Amount | 76263.51 |
| Total Medical Medicare Payment Amount | 54227.49 |
| Total Medical Medicare Standardized Payment Amount | 65499.21 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 208 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 386 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 462 |
| Number Of Black or African American Beneficiaries | 75 |
| 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 | 531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3582 |