National Provider Identifier [NPI]: |
1023202322 |
Last Name Of The Provider |
FELSL |
First Name Of The Provider |
ANNA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PHD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 W RENNER RD |
Street Address 2 Of The Provider |
APT. 1424 |
City Of The Provider |
RICHARDSON |
Zip Code Of The Provider |
750801028 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
2528 |
Number Of Medicare Beneficiaries |
188 |
Total Submitted Charge Amount |
373740 |
Total Medicare Allowed Amount |
225481.68 |
Total Medicare Payment Amount |
174937.62 |
Total Medicare Standardized Payment Amount |
155329.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
2528 |
Number Of Medicare Beneficiaries With Medical Services |
188 |
Total Medical Submitted Charge Amount |
373740 |
Total Medical Medicare Allowed Amount |
225481.68 |
Total Medical Medicare Payment Amount |
174937.62 |
Total Medical Medicare Standardized Payment Amount |
155329.47 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
88 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
43 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
145 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
30 |
Percent Of With Stroke |
29 |
Average HCC Risk Score Of Beneficiaries |
2.8734 |