National Provider Identifier [NPI]: |
1811009343 |
Last Name Of The Provider |
BEVIS |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3311 E MURDOCK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WICHITA |
Zip Code Of The Provider |
672083054 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
134 |
Number Of Medicare Beneficiaries |
61 |
Total Submitted Charge Amount |
7021 |
Total Medicare Allowed Amount |
3807.16 |
Total Medicare Payment Amount |
2333.11 |
Total Medicare Standardized Payment Amount |
3136.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
56 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
340 |
Total Drug Medicare AllowedAmount |
127.26 |
Total Drug Medicare PaymentAmount |
98 |
Total Drug Medicare Standardized Payment Amount |
98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
78 |
Number Of Medicare Beneficiaries With Medical Services |
61 |
Total Medical Submitted Charge Amount |
6681 |
Total Medical Medicare Allowed Amount |
3679.9 |
Total Medical Medicare Payment Amount |
2235.11 |
Total Medical Medicare Standardized Payment Amount |
3038.27 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
16 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
43 |
Number Of Male Beneficiaries |
18 |
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 |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
26 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9172 |