National Provider Identifier [NPI]: |
1831352285 |
Last Name Of The Provider |
BRADSTREET |
First Name Of The Provider |
ERIC |
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 |
20375 W 151ST ST |
Street Address 2 Of The Provider |
SUITE 306 |
City Of The Provider |
OLATHE |
Zip Code Of The Provider |
660615306 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
559 |
Number Of Medicare Beneficiaries |
481 |
Total Submitted Charge Amount |
321584.68 |
Total Medicare Allowed Amount |
63381.35 |
Total Medicare Payment Amount |
49435.78 |
Total Medicare Standardized Payment Amount |
51038.24 |
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 |
79 |
Number Of Medical Services |
559 |
Number Of Medicare Beneficiaries With Medical Services |
481 |
Total Medical Submitted Charge Amount |
321584.68 |
Total Medical Medicare Allowed Amount |
63381.35 |
Total Medical Medicare Payment Amount |
49435.78 |
Total Medical Medicare Standardized Payment Amount |
51038.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
207 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
449 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
401 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5362 |