National Provider Identifier [NPI]: |
1689829376 |
Last Name Of The Provider |
CASTRO |
First Name Of The Provider |
FIDEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M. D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
929 N SAINT FRANCIS ST |
Street Address 2 Of The Provider |
EMERGENCY DEPT. |
City Of The Provider |
WICHITA |
Zip Code Of The Provider |
672143821 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1953 |
Number Of Medicare Beneficiaries |
1644 |
Total Submitted Charge Amount |
430100 |
Total Medicare Allowed Amount |
162379.81 |
Total Medicare Payment Amount |
125129.82 |
Total Medicare Standardized Payment Amount |
128873.21 |
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 |
26 |
Number Of Medical Services |
1953 |
Number Of Medicare Beneficiaries With Medical Services |
1644 |
Total Medical Submitted Charge Amount |
430100 |
Total Medical Medicare Allowed Amount |
162379.81 |
Total Medical Medicare Payment Amount |
125129.82 |
Total Medical Medicare Standardized Payment Amount |
128873.21 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
533 |
Number Of Beneficiaries Age 65 to 74 |
391 |
Number Of Beneficiaries Age 75 to 84 |
413 |
Number Of Beneficiaries Age Greater 84 |
307 |
Number Of Female Beneficiaries |
944 |
Number Of Male Beneficiaries |
700 |
Number Of Non Hispanic White Beneficiaries |
1330 |
Number Of Black or African American Beneficiaries |
196 |
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
75 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1039 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
605 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9235 |