National Provider Identifier [NPI]: |
1215196241 |
Last Name Of The Provider |
BOONE |
First Name Of The Provider |
KATHERINE |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5255 E STOP 11 RD |
Street Address 2 Of The Provider |
SUITE 450 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462376340 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
157 |
Number Of Medicare Beneficiaries |
141 |
Total Submitted Charge Amount |
161943 |
Total Medicare Allowed Amount |
13404.2 |
Total Medicare Payment Amount |
10355.54 |
Total Medicare Standardized Payment Amount |
11150.03 |
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 |
30 |
Number Of Medical Services |
157 |
Number Of Medicare Beneficiaries With Medical Services |
141 |
Total Medical Submitted Charge Amount |
161943 |
Total Medical Medicare Allowed Amount |
13404.2 |
Total Medical Medicare Payment Amount |
10355.54 |
Total Medical Medicare Standardized Payment Amount |
11150.03 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
66 |
Number Of Male Beneficiaries |
75 |
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 |
109 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4443 |