National Provider Identifier [NPI]: |
1407882004 |
Last Name Of The Provider |
SIAN |
First Name Of The Provider |
KENTY |
Middle Initial Of The Provider |
U |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1855 E ALLUVIAL AVE |
Street Address 2 Of The Provider |
STE. 101 |
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937203854 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Plastic and Reconstructive Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
1334 |
Number Of Medicare Beneficiaries |
207 |
Total Submitted Charge Amount |
262564 |
Total Medicare Allowed Amount |
123317.14 |
Total Medicare Payment Amount |
94349.21 |
Total Medicare Standardized Payment Amount |
90420.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
718 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
32050 |
Total Drug Medicare AllowedAmount |
24642.61 |
Total Drug Medicare PaymentAmount |
19318.39 |
Total Drug Medicare Standardized Payment Amount |
19318.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
97 |
Number Of Medical Services |
616 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
230514 |
Total Medical Medicare Allowed Amount |
98674.53 |
Total Medical Medicare Payment Amount |
75030.82 |
Total Medical Medicare Standardized Payment Amount |
71102.26 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
144 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2901 |