| National Provider Identifier [NPI]: | 1861443459 |
| Last Name Of The Provider | MOUSSA |
| First Name Of The Provider | JANY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| 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 | 28 |
| Number Of Services | 4777 |
| Number Of Medicare Beneficiaries | 884 |
| Total Submitted Charge Amount | 1106904 |
| Total Medicare Allowed Amount | 369922.15 |
| Total Medicare Payment Amount | 275736.65 |
| Total Medicare Standardized Payment Amount | 296378.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 939 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 30426 |
| Total Drug Medicare AllowedAmount | 10833.41 |
| Total Drug Medicare PaymentAmount | 8008.62 |
| Total Drug Medicare Standardized Payment Amount | 8008.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 3838 |
| Number Of Medicare Beneficiaries With Medical Services | 884 |
| Total Medical Submitted Charge Amount | 1076478 |
| Total Medical Medicare Allowed Amount | 359088.74 |
| Total Medical Medicare Payment Amount | 267728.03 |
| Total Medical Medicare Standardized Payment Amount | 288369.95 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 205 |
| Number Of Beneficiaries Age 65 to 74 | 280 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 150 |
| Number Of Female Beneficiaries | 447 |
| Number Of Male Beneficiaries | 437 |
| Number Of Non Hispanic White Beneficiaries | 686 |
| Number Of Black or African American Beneficiaries | 132 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 660 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 224 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 3.416 |