National Provider Identifier [NPI]: |
1952381485 |
Last Name Of The Provider |
BURBACH |
First Name Of The Provider |
NICHOLAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7550 WEST VILLAGE CIRCLE |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
WICHITA |
Zip Code Of The Provider |
67205 |
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 |
24 |
Number Of Services |
182 |
Number Of Medicare Beneficiaries |
68 |
Total Submitted Charge Amount |
145094 |
Total Medicare Allowed Amount |
8328.01 |
Total Medicare Payment Amount |
6193.06 |
Total Medicare Standardized Payment Amount |
6861.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1610 |
Total Drug Medicare AllowedAmount |
1118.25 |
Total Drug Medicare PaymentAmount |
873.91 |
Total Drug Medicare Standardized Payment Amount |
873.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
134 |
Number Of Medicare Beneficiaries With Medical Services |
68 |
Total Medical Submitted Charge Amount |
143484 |
Total Medical Medicare Allowed Amount |
7209.76 |
Total Medical Medicare Payment Amount |
5319.15 |
Total Medical Medicare Standardized Payment Amount |
5987.44 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
32 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
29 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.9239 |