| National Provider Identifier [NPI]: | 1053453142 |
| Last Name Of The Provider | BORST |
| First Name Of The Provider | ELLEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1131 S CLIFTON AVE |
| Street Address 2 Of The Provider | S-B |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672182955 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 2645 |
| Number Of Medicare Beneficiaries | 808 |
| Total Submitted Charge Amount | 601024 |
| Total Medicare Allowed Amount | 293787.31 |
| Total Medicare Payment Amount | 229149.54 |
| Total Medicare Standardized Payment Amount | 238363.22 |
| 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 | 18 |
| Number Of Medical Services | 2645 |
| Number Of Medicare Beneficiaries With Medical Services | 808 |
| Total Medical Submitted Charge Amount | 601024 |
| Total Medical Medicare Allowed Amount | 293787.31 |
| Total Medical Medicare Payment Amount | 229149.54 |
| Total Medical Medicare Standardized Payment Amount | 238363.22 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 216 |
| Number Of Beneficiaries Age 75 to 84 | 267 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 461 |
| Number Of Male Beneficiaries | 347 |
| Number Of Non Hispanic White Beneficiaries | 711 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 588 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 220 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 64 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4725 |