National Provider Identifier [NPI]: |
1235103714 |
Last Name Of The Provider |
KUNKEL |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2203 E LITTLE CREEK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORFOLK |
Zip Code Of The Provider |
235184205 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
4748 |
Number Of Medicare Beneficiaries |
462 |
Total Submitted Charge Amount |
314851 |
Total Medicare Allowed Amount |
185474.53 |
Total Medicare Payment Amount |
129361.31 |
Total Medicare Standardized Payment Amount |
132688.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
1217 |
Number Of Medicare Beneficiaries With Drug Services |
240 |
Total Drug Submitted ChargeAmount |
18811 |
Total Drug Medicare AllowedAmount |
8548.82 |
Total Drug Medicare PaymentAmount |
7956.36 |
Total Drug Medicare Standardized Payment Amount |
7956.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
98 |
Number Of Medical Services |
3531 |
Number Of Medicare Beneficiaries With Medical Services |
462 |
Total Medical Submitted Charge Amount |
296040 |
Total Medical Medicare Allowed Amount |
176925.71 |
Total Medical Medicare Payment Amount |
121404.95 |
Total Medical Medicare Standardized Payment Amount |
124732.36 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
252 |
Number Of Non Hispanic White Beneficiaries |
310 |
Number Of Black or African American Beneficiaries |
121 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2114 |