National Provider Identifier [NPI]: |
1275631848 |
Last Name Of The Provider |
BUTELL |
First Name Of The Provider |
SARAH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
23450 COLLEGE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
OLATHE |
Zip Code Of The Provider |
660618702 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
392 |
Number Of Medicare Beneficiaries |
152 |
Total Submitted Charge Amount |
24330 |
Total Medicare Allowed Amount |
12546.8 |
Total Medicare Payment Amount |
8030.32 |
Total Medicare Standardized Payment Amount |
10281.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
1120 |
Total Drug Medicare AllowedAmount |
703.84 |
Total Drug Medicare PaymentAmount |
663.45 |
Total Drug Medicare Standardized Payment Amount |
663.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
353 |
Number Of Medicare Beneficiaries With Medical Services |
152 |
Total Medical Submitted Charge Amount |
23210 |
Total Medical Medicare Allowed Amount |
11842.96 |
Total Medical Medicare Payment Amount |
7366.87 |
Total Medical Medicare Standardized Payment Amount |
9618.21 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
135 |
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 |
111 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8695 |