| National Provider Identifier [NPI]: | 1922157577 |
| Last Name Of The Provider | KHICHA |
| First Name Of The Provider | AMISHA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 551 N HILLSIDE ST |
| Street Address 2 Of The Provider | SUITE 320 |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672144923 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 6740 |
| Number Of Medicare Beneficiaries | 3116 |
| Total Submitted Charge Amount | 756972.51 |
| Total Medicare Allowed Amount | 301442.87 |
| Total Medicare Payment Amount | 256178.97 |
| Total Medicare Standardized Payment Amount | 278694.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1431 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 820.1 |
| Total Drug Medicare AllowedAmount | 752.94 |
| Total Drug Medicare PaymentAmount | 576.75 |
| Total Drug Medicare Standardized Payment Amount | 576.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 141 |
| Number Of Medical Services | 5309 |
| Number Of Medicare Beneficiaries With Medical Services | 3116 |
| Total Medical Submitted Charge Amount | 756152.41 |
| Total Medical Medicare Allowed Amount | 300689.93 |
| Total Medical Medicare Payment Amount | 255602.22 |
| Total Medical Medicare Standardized Payment Amount | 278117.43 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 416 |
| Number Of Beneficiaries Age 65 to 74 | 1338 |
| Number Of Beneficiaries Age 75 to 84 | 897 |
| Number Of Beneficiaries Age Greater 84 | 465 |
| Number Of Female Beneficiaries | 2408 |
| Number Of Male Beneficiaries | 708 |
| Number Of Non Hispanic White Beneficiaries | 2755 |
| Number Of Black or African American Beneficiaries | 210 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2638 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 478 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3004 |