National Provider Identifier [NPI]: |
1255648481 |
Last Name Of The Provider |
ERB |
First Name Of The Provider |
KENTON |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 SW 10TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TOPEKA |
Zip Code Of The Provider |
666041301 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
591 |
Number Of Medicare Beneficiaries |
301 |
Total Submitted Charge Amount |
238016 |
Total Medicare Allowed Amount |
41794.21 |
Total Medicare Payment Amount |
31792.47 |
Total Medicare Standardized Payment Amount |
35589.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
156 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
975 |
Total Drug Medicare AllowedAmount |
276.07 |
Total Drug Medicare PaymentAmount |
205.02 |
Total Drug Medicare Standardized Payment Amount |
205.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
435 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
237041 |
Total Medical Medicare Allowed Amount |
41518.14 |
Total Medical Medicare Payment Amount |
31587.45 |
Total Medical Medicare Standardized Payment Amount |
35384.35 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
182 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
13 |
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 |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.134 |