National Provider Identifier [NPI]: |
1356344709 |
Last Name Of The Provider |
VAUGHN |
First Name Of The Provider |
SHERRI |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1130 W 4TH ST |
Street Address 2 Of The Provider |
SUITE 3200 |
City Of The Provider |
LAWRENCE |
Zip Code Of The Provider |
660441328 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
749 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
81203 |
Total Medicare Allowed Amount |
35881.43 |
Total Medicare Payment Amount |
25569.19 |
Total Medicare Standardized Payment Amount |
27530.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
212 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
2476 |
Total Drug Medicare AllowedAmount |
1114.74 |
Total Drug Medicare PaymentAmount |
981.55 |
Total Drug Medicare Standardized Payment Amount |
981.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
537 |
Number Of Medicare Beneficiaries With Medical Services |
128 |
Total Medical Submitted Charge Amount |
78727 |
Total Medical Medicare Allowed Amount |
34766.69 |
Total Medical Medicare Payment Amount |
24587.64 |
Total Medical Medicare Standardized Payment Amount |
26549.31 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
21 |
Number Of Non Hispanic White Beneficiaries |
117 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8627 |