National Provider Identifier [NPI]: |
1043543028 |
Last Name Of The Provider |
ELLIOTT |
First Name Of The Provider |
LAHNA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
P.A.-C. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10202 W 13TH ST N |
Street Address 2 Of The Provider |
|
City Of The Provider |
WICHITA |
Zip Code Of The Provider |
672124377 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
466 |
Number Of Medicare Beneficiaries |
78 |
Total Submitted Charge Amount |
38141 |
Total Medicare Allowed Amount |
21523.5 |
Total Medicare Payment Amount |
15562.28 |
Total Medicare Standardized Payment Amount |
19878.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
107 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
996 |
Total Drug Medicare AllowedAmount |
242.59 |
Total Drug Medicare PaymentAmount |
135.76 |
Total Drug Medicare Standardized Payment Amount |
135.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
359 |
Number Of Medicare Beneficiaries With Medical Services |
77 |
Total Medical Submitted Charge Amount |
37145 |
Total Medical Medicare Allowed Amount |
21280.91 |
Total Medical Medicare Payment Amount |
15426.52 |
Total Medical Medicare Standardized Payment Amount |
19742.69 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
14 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
46 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1959 |