National Provider Identifier [NPI]: |
1619162179 |
Last Name Of The Provider |
KEMPER |
First Name Of The Provider |
LANCE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEARCY |
Zip Code Of The Provider |
721434802 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
2476 |
Number Of Medicare Beneficiaries |
702 |
Total Submitted Charge Amount |
179063 |
Total Medicare Allowed Amount |
75428.7 |
Total Medicare Payment Amount |
54965.32 |
Total Medicare Standardized Payment Amount |
69712.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
2476 |
Number Of Medicare Beneficiaries With Medical Services |
702 |
Total Medical Submitted Charge Amount |
179063 |
Total Medical Medicare Allowed Amount |
75428.7 |
Total Medical Medicare Payment Amount |
54965.32 |
Total Medical Medicare Standardized Payment Amount |
69712.23 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
159 |
Number Of Beneficiaries Age 65 to 74 |
230 |
Number Of Beneficiaries Age 75 to 84 |
209 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
479 |
Number Of Male Beneficiaries |
223 |
Number Of Non Hispanic White Beneficiaries |
669 |
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 |
486 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
216 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1871 |