National Provider Identifier [NPI]: |
1255497889 |
Last Name Of The Provider |
KUGLER |
First Name Of The Provider |
CARRIE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2115 S FREMONT AVE |
Street Address 2 Of The Provider |
SUITE 2300 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042239 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
335 |
Number Of Medicare Beneficiaries |
222 |
Total Submitted Charge Amount |
36527 |
Total Medicare Allowed Amount |
21453.54 |
Total Medicare Payment Amount |
16711.37 |
Total Medicare Standardized Payment Amount |
21109.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
1362 |
Total Drug Medicare AllowedAmount |
922.95 |
Total Drug Medicare PaymentAmount |
885.22 |
Total Drug Medicare Standardized Payment Amount |
885.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
296 |
Number Of Medicare Beneficiaries With Medical Services |
222 |
Total Medical Submitted Charge Amount |
35165 |
Total Medical Medicare Allowed Amount |
20530.59 |
Total Medical Medicare Payment Amount |
15826.15 |
Total Medical Medicare Standardized Payment Amount |
20224.39 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
130 |
Number Of Male Beneficiaries |
92 |
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.2636 |