National Provider Identifier [NPI]: |
1396772083 |
Last Name Of The Provider |
ELSON |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 E HARRY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WICHITA |
Zip Code Of The Provider |
672183713 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
152 |
Number Of Services |
23475 |
Number Of Medicare Beneficiaries |
2487 |
Total Submitted Charge Amount |
990698.5 |
Total Medicare Allowed Amount |
341364.22 |
Total Medicare Payment Amount |
270326.35 |
Total Medicare Standardized Payment Amount |
302261.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
19328 |
Number Of Medicare Beneficiaries With Drug Services |
234 |
Total Drug Submitted ChargeAmount |
33462 |
Total Drug Medicare AllowedAmount |
3704.77 |
Total Drug Medicare PaymentAmount |
2755.95 |
Total Drug Medicare Standardized Payment Amount |
2755.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
150 |
Number Of Medical Services |
4147 |
Number Of Medicare Beneficiaries With Medical Services |
2486 |
Total Medical Submitted Charge Amount |
957236.5 |
Total Medical Medicare Allowed Amount |
337659.45 |
Total Medical Medicare Payment Amount |
267570.4 |
Total Medical Medicare Standardized Payment Amount |
299505.29 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
280 |
Number Of Beneficiaries Age 65 to 74 |
1078 |
Number Of Beneficiaries Age 75 to 84 |
799 |
Number Of Beneficiaries Age Greater 84 |
330 |
Number Of Female Beneficiaries |
1735 |
Number Of Male Beneficiaries |
752 |
Number Of Non Hispanic White Beneficiaries |
2260 |
Number Of Black or African American Beneficiaries |
126 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
22 |
Number Of Beneficiaries With Medicare Only Entitlement |
2224 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
263 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.116 |