| National Provider Identifier [NPI]: | 1649287814 |
| Last Name Of The Provider | WARNER |
| First Name Of The Provider | SIDNEY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 520 E EUCLID AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782124414 |
| 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 | 8 |
| Number Of Services | 560 |
| Number Of Medicare Beneficiaries | 407 |
| Total Submitted Charge Amount | 49355 |
| Total Medicare Allowed Amount | 31571.63 |
| Total Medicare Payment Amount | 22980.19 |
| Total Medicare Standardized Payment Amount | 29040.1 |
| 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 | 8 |
| Number Of Medical Services | 560 |
| Number Of Medicare Beneficiaries With Medical Services | 407 |
| Total Medical Submitted Charge Amount | 49355 |
| Total Medical Medicare Allowed Amount | 31571.63 |
| Total Medical Medicare Payment Amount | 22980.19 |
| Total Medical Medicare Standardized Payment Amount | 29040.1 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | 291 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 381 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0064 |