National Provider Identifier [NPI]: |
1194865733 |
Last Name Of The Provider |
KENSIL |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9155 SW BARNES RD |
Street Address 2 Of The Provider |
STE 422 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972256625 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
772 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
214356.1 |
Total Medicare Allowed Amount |
37699.66 |
Total Medicare Payment Amount |
28567.39 |
Total Medicare Standardized Payment Amount |
31765.81 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
216 |
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 |
214 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
28 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2436 |