| National Provider Identifier [NPI]: | 1679503965 |
| Last Name Of The Provider | DEKERLEGAND |
| First Name Of The Provider | DIRK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | P.A.C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4103 S MEDFORD DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LUFKIN |
| Zip Code Of The Provider | 759015633 |
| 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 | 9 |
| Number Of Services | 14464 |
| Number Of Medicare Beneficiaries | 155 |
| Total Submitted Charge Amount | 187113.08 |
| Total Medicare Allowed Amount | 140158.95 |
| Total Medicare Payment Amount | 104465.45 |
| Total Medicare Standardized Payment Amount | 112699.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 13748 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 103278.08 |
| Total Drug Medicare AllowedAmount | 96905.71 |
| Total Drug Medicare PaymentAmount | 74931.21 |
| Total Drug Medicare Standardized Payment Amount | 74931.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 5 |
| Number Of Medical Services | 716 |
| Number Of Medicare Beneficiaries With Medical Services | 155 |
| Total Medical Submitted Charge Amount | 83835 |
| Total Medical Medicare Allowed Amount | 43253.24 |
| Total Medical Medicare Payment Amount | 29534.24 |
| Total Medical Medicare Standardized Payment Amount | 37768.3 |
| Average Age Of Beneficiaries | 47 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 87 |
| Number Of Black or African American Beneficiaries | 55 |
| 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 | 40 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 63 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 54 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.192 |