National Provider Identifier [NPI]: |
1972768620 |
Last Name Of The Provider |
KAISER |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2750 BROADWAY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOULDER |
Zip Code Of The Provider |
803043573 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1748 |
Number Of Medicare Beneficiaries |
162 |
Total Submitted Charge Amount |
94293.5 |
Total Medicare Allowed Amount |
51472.96 |
Total Medicare Payment Amount |
38785.21 |
Total Medicare Standardized Payment Amount |
39898.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
1378 |
Number Of Medicare Beneficiaries With Drug Services |
80 |
Total Drug Submitted ChargeAmount |
37310.72 |
Total Drug Medicare AllowedAmount |
26897.7 |
Total Drug Medicare PaymentAmount |
20820.65 |
Total Drug Medicare Standardized Payment Amount |
20820.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
370 |
Number Of Medicare Beneficiaries With Medical Services |
162 |
Total Medical Submitted Charge Amount |
56982.78 |
Total Medical Medicare Allowed Amount |
24575.26 |
Total Medical Medicare Payment Amount |
17964.56 |
Total Medical Medicare Standardized Payment Amount |
19077.41 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
149 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
13 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8 |