| National Provider Identifier [NPI]: | 1043224603 |
| Last Name Of The Provider | BLISS |
| First Name Of The Provider | KIRK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8200 W CENTRAL AVE |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672129503 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 3979.5 |
| Number Of Medicare Beneficiaries | 319 |
| Total Submitted Charge Amount | 305366 |
| Total Medicare Allowed Amount | 163833.39 |
| Total Medicare Payment Amount | 123533.93 |
| Total Medicare Standardized Payment Amount | 135055.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 535.5 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 17385 |
| Total Drug Medicare AllowedAmount | 9105.82 |
| Total Drug Medicare PaymentAmount | 7614.53 |
| Total Drug Medicare Standardized Payment Amount | 7614.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 168 |
| Number Of Medical Services | 3444 |
| Number Of Medicare Beneficiaries With Medical Services | 319 |
| Total Medical Submitted Charge Amount | 287981 |
| Total Medical Medicare Allowed Amount | 154727.57 |
| Total Medical Medicare Payment Amount | 115919.4 |
| Total Medical Medicare Standardized Payment Amount | 127440.87 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 188 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 295 |
| 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 | 306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0679 |