National Provider Identifier [NPI]: |
1588622153 |
Last Name Of The Provider |
POWERS |
First Name Of The Provider |
KATRINA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
206 NW MOCK AVE |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
BLUE SPRINGS |
Zip Code Of The Provider |
640142507 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1681 |
Number Of Medicare Beneficiaries |
388 |
Total Submitted Charge Amount |
149866 |
Total Medicare Allowed Amount |
115337.13 |
Total Medicare Payment Amount |
80165.5 |
Total Medicare Standardized Payment Amount |
82459.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
142 |
Number Of Medicare Beneficiaries With Drug Services |
82 |
Total Drug Submitted ChargeAmount |
4011 |
Total Drug Medicare AllowedAmount |
2827.63 |
Total Drug Medicare PaymentAmount |
2720.61 |
Total Drug Medicare Standardized Payment Amount |
2720.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1539 |
Number Of Medicare Beneficiaries With Medical Services |
387 |
Total Medical Submitted Charge Amount |
145855 |
Total Medical Medicare Allowed Amount |
112509.5 |
Total Medical Medicare Payment Amount |
77444.89 |
Total Medical Medicare Standardized Payment Amount |
79738.97 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
211 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
262 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
363 |
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 |
373 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.832 |