| National Provider Identifier [NPI]: | 1780651968 |
| Last Name Of The Provider | KUEBKER |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9480 HUEBNER RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782401655 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1118 |
| Number Of Medicare Beneficiaries | 173 |
| Total Submitted Charge Amount | 71132.65 |
| Total Medicare Allowed Amount | 62071.62 |
| Total Medicare Payment Amount | 48301.62 |
| Total Medicare Standardized Payment Amount | 53092.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 112 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 3745.37 |
| Total Drug Medicare AllowedAmount | 3217.86 |
| Total Drug Medicare PaymentAmount | 3137.12 |
| Total Drug Medicare Standardized Payment Amount | 3137.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 1006 |
| Number Of Medicare Beneficiaries With Medical Services | 173 |
| Total Medical Submitted Charge Amount | 67387.28 |
| Total Medical Medicare Allowed Amount | 58853.76 |
| Total Medical Medicare Payment Amount | 45164.5 |
| Total Medical Medicare Standardized Payment Amount | 49955.14 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 87 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 158 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0375 |