| National Provider Identifier [NPI]: | 1972618890 |
| Last Name Of The Provider | GENCK |
| First Name Of The Provider | ROD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 680 E DEUCE OF CLUBS |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | SHOW LOW |
| Zip Code Of The Provider | 859014827 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 2194 |
| Number Of Medicare Beneficiaries | 710 |
| Total Submitted Charge Amount | 288528 |
| Total Medicare Allowed Amount | 95316.67 |
| Total Medicare Payment Amount | 66206.73 |
| Total Medicare Standardized Payment Amount | 79777.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 880 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 10792 |
| Total Drug Medicare AllowedAmount | 1070.16 |
| Total Drug Medicare PaymentAmount | 772.17 |
| Total Drug Medicare Standardized Payment Amount | 772.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 1314 |
| Number Of Medicare Beneficiaries With Medical Services | 710 |
| Total Medical Submitted Charge Amount | 277736 |
| Total Medical Medicare Allowed Amount | 94246.51 |
| Total Medical Medicare Payment Amount | 65434.56 |
| Total Medical Medicare Standardized Payment Amount | 79004.99 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 348 |
| Number Of Beneficiaries Age 75 to 84 | 228 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 405 |
| Number Of Male Beneficiaries | 305 |
| Number Of Non Hispanic White Beneficiaries | 659 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 629 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8893 |