National Provider Identifier [NPI]: |
1992756563 |
Last Name Of The Provider |
CHALLA |
First Name Of The Provider |
USHASRI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
818 N EMPORIA ST |
Street Address 2 Of The Provider |
SUITE 310 |
City Of The Provider |
WICHITA |
Zip Code Of The Provider |
672143729 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
4385 |
Number Of Medicare Beneficiaries |
815 |
Total Submitted Charge Amount |
1272948 |
Total Medicare Allowed Amount |
426032.95 |
Total Medicare Payment Amount |
326019.67 |
Total Medicare Standardized Payment Amount |
343662.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
451 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
14394 |
Total Drug Medicare AllowedAmount |
5138.51 |
Total Drug Medicare PaymentAmount |
3804.38 |
Total Drug Medicare Standardized Payment Amount |
3804.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
3934 |
Number Of Medicare Beneficiaries With Medical Services |
815 |
Total Medical Submitted Charge Amount |
1258554 |
Total Medical Medicare Allowed Amount |
420894.44 |
Total Medical Medicare Payment Amount |
322215.29 |
Total Medical Medicare Standardized Payment Amount |
339857.86 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
234 |
Number Of Beneficiaries Age 65 to 74 |
231 |
Number Of Beneficiaries Age 75 to 84 |
237 |
Number Of Beneficiaries Age Greater 84 |
113 |
Number Of Female Beneficiaries |
425 |
Number Of Male Beneficiaries |
390 |
Number Of Non Hispanic White Beneficiaries |
612 |
Number Of Black or African American Beneficiaries |
135 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
522 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
293 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
4.0029 |