National Provider Identifier [NPI]: |
1225397672 |
Last Name Of The Provider |
MCKINLEY |
First Name Of The Provider |
TRACIE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5219 CITY BANK PKWY STE 160 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUBBOCK |
Zip Code Of The Provider |
794073544 |
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 |
55 |
Number Of Services |
1246 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
64047 |
Total Medicare Allowed Amount |
27363.76 |
Total Medicare Payment Amount |
19707.29 |
Total Medicare Standardized Payment Amount |
24416.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
519 |
Number Of Medicare Beneficiaries With Drug Services |
87 |
Total Drug Submitted ChargeAmount |
6893 |
Total Drug Medicare AllowedAmount |
1212.08 |
Total Drug Medicare PaymentAmount |
997.7 |
Total Drug Medicare Standardized Payment Amount |
997.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
727 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
57154 |
Total Medical Medicare Allowed Amount |
26151.68 |
Total Medical Medicare Payment Amount |
18709.59 |
Total Medical Medicare Standardized Payment Amount |
23418.59 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
202 |
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 |
204 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.835 |