| National Provider Identifier [NPI]: | 1144258484 |
| Last Name Of The Provider | BUI |
| First Name Of The Provider | CHARLENE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7111 E 21ST STREET N |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 67206 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 1241 |
| Number Of Medicare Beneficiaries | 314 |
| Total Submitted Charge Amount | 70484.5 |
| Total Medicare Allowed Amount | 35200.14 |
| Total Medicare Payment Amount | 25702.07 |
| Total Medicare Standardized Payment Amount | 32620.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 420 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 7225.5 |
| Total Drug Medicare AllowedAmount | 3907.91 |
| Total Drug Medicare PaymentAmount | 3544.38 |
| Total Drug Medicare Standardized Payment Amount | 3544.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 821 |
| Number Of Medicare Beneficiaries With Medical Services | 314 |
| Total Medical Submitted Charge Amount | 63259 |
| Total Medical Medicare Allowed Amount | 31292.23 |
| Total Medical Medicare Payment Amount | 22157.69 |
| Total Medical Medicare Standardized Payment Amount | 29076.05 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 139 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 259 |
| Number Of Black or African American Beneficiaries | 34 |
| 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 | 277 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.99 |