| National Provider Identifier [NPI]: | 1427354406 |
| Last Name Of The Provider | SOLANO |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4200 SOUTH FWY |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761151400 |
| 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 | 38 |
| Number Of Services | 546 |
| Number Of Medicare Beneficiaries | 55 |
| Total Submitted Charge Amount | 49399.55 |
| Total Medicare Allowed Amount | 20054.8 |
| Total Medicare Payment Amount | 14985.95 |
| Total Medicare Standardized Payment Amount | 17273.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 342 |
| Total Drug Medicare AllowedAmount | 98.88 |
| Total Drug Medicare PaymentAmount | 95.7 |
| Total Drug Medicare Standardized Payment Amount | 95.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 522 |
| Number Of Medicare Beneficiaries With Medical Services | 55 |
| Total Medical Submitted Charge Amount | 49057.55 |
| Total Medical Medicare Allowed Amount | 19955.92 |
| Total Medical Medicare Payment Amount | 14890.25 |
| Total Medical Medicare Standardized Payment Amount | 17177.75 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 27 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 25 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| 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 | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0243 |