National Provider Identifier [NPI]: |
1982651824 |
Last Name Of The Provider |
BOTROS |
First Name Of The Provider |
MAGED |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
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 |
|
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 |
33 |
Number Of Services |
2106 |
Number Of Medicare Beneficiaries |
1712 |
Total Submitted Charge Amount |
431747 |
Total Medicare Allowed Amount |
159489.69 |
Total Medicare Payment Amount |
120943.72 |
Total Medicare Standardized Payment Amount |
124827.54 |
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 |
33 |
Number Of Medical Services |
2106 |
Number Of Medicare Beneficiaries With Medical Services |
1712 |
Total Medical Submitted Charge Amount |
431747 |
Total Medical Medicare Allowed Amount |
159489.69 |
Total Medical Medicare Payment Amount |
120943.72 |
Total Medical Medicare Standardized Payment Amount |
124827.54 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
586 |
Number Of Beneficiaries Age 65 to 74 |
429 |
Number Of Beneficiaries Age 75 to 84 |
399 |
Number Of Beneficiaries Age Greater 84 |
298 |
Number Of Female Beneficiaries |
986 |
Number Of Male Beneficiaries |
726 |
Number Of Non Hispanic White Beneficiaries |
1352 |
Number Of Black or African American Beneficiaries |
233 |
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
84 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1037 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
675 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9686 |