National Provider Identifier [NPI]: |
1891928537 |
Last Name Of The Provider |
SANNING |
First Name Of The Provider |
MICAH |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1218 S BROADWAY |
Street Address 2 Of The Provider |
STE 310 |
City Of The Provider |
LEXINGTON |
Zip Code Of The Provider |
405042759 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
633 |
Number Of Medicare Beneficiaries |
375 |
Total Submitted Charge Amount |
306559 |
Total Medicare Allowed Amount |
47643.67 |
Total Medicare Payment Amount |
36125.18 |
Total Medicare Standardized Payment Amount |
44268.64 |
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 |
40 |
Number Of Medical Services |
633 |
Number Of Medicare Beneficiaries With Medical Services |
375 |
Total Medical Submitted Charge Amount |
306559 |
Total Medical Medicare Allowed Amount |
47643.67 |
Total Medical Medicare Payment Amount |
36125.18 |
Total Medical Medicare Standardized Payment Amount |
44268.64 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
157 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
354 |
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 |
172 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.691 |