National Provider Identifier [NPI]: |
1578849816 |
Last Name Of The Provider |
KAN |
First Name Of The Provider |
AARON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
127 N MCKINLEY ST |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
CORONA |
Zip Code Of The Provider |
928796563 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
380 |
Number Of Medicare Beneficiaries |
328 |
Total Submitted Charge Amount |
187936 |
Total Medicare Allowed Amount |
37941.67 |
Total Medicare Payment Amount |
29082.98 |
Total Medicare Standardized Payment Amount |
32720.58 |
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 |
23 |
Number Of Medical Services |
380 |
Number Of Medicare Beneficiaries With Medical Services |
328 |
Total Medical Submitted Charge Amount |
187936 |
Total Medical Medicare Allowed Amount |
37941.67 |
Total Medical Medicare Payment Amount |
29082.98 |
Total Medical Medicare Standardized Payment Amount |
32720.58 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
190 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
59 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
134 |
Number Of Hispanic Beneficiaries |
107 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
276 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
24 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.3621 |