National Provider Identifier [NPI]: |
1487853230 |
Last Name Of The Provider |
CORAY |
First Name Of The Provider |
AARON |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
750 BROADWAY |
Street Address 2 Of The Provider |
SUITE 150 |
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468021412 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
805 |
Number Of Medicare Beneficiaries |
295 |
Total Submitted Charge Amount |
58277 |
Total Medicare Allowed Amount |
45537.71 |
Total Medicare Payment Amount |
33889.92 |
Total Medicare Standardized Payment Amount |
35254.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
92 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
2255 |
Total Drug Medicare AllowedAmount |
1010.11 |
Total Drug Medicare PaymentAmount |
957.72 |
Total Drug Medicare Standardized Payment Amount |
957.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
713 |
Number Of Medicare Beneficiaries With Medical Services |
295 |
Total Medical Submitted Charge Amount |
56022 |
Total Medical Medicare Allowed Amount |
44527.6 |
Total Medical Medicare Payment Amount |
32932.2 |
Total Medical Medicare Standardized Payment Amount |
34297.13 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
174 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
213 |
Number Of Black or African American Beneficiaries |
66 |
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 |
79 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
216 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5104 |