National Provider Identifier [NPI]: |
1336257203 |
Last Name Of The Provider |
KUEHN |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
505 39TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
AMANA |
Zip Code Of The Provider |
522038229 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
623 |
Number Of Medicare Beneficiaries |
166 |
Total Submitted Charge Amount |
34503 |
Total Medicare Allowed Amount |
27383.52 |
Total Medicare Payment Amount |
18736.65 |
Total Medicare Standardized Payment Amount |
24342.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
2131 |
Total Drug Medicare AllowedAmount |
1770.02 |
Total Drug Medicare PaymentAmount |
1621.56 |
Total Drug Medicare Standardized Payment Amount |
1621.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
585 |
Number Of Medicare Beneficiaries With Medical Services |
166 |
Total Medical Submitted Charge Amount |
32372 |
Total Medical Medicare Allowed Amount |
25613.5 |
Total Medical Medicare Payment Amount |
17115.09 |
Total Medical Medicare Standardized Payment Amount |
22720.64 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8718 |