National Provider Identifier [NPI]: |
1134130925 |
Last Name Of The Provider |
KORNBLUTH |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1746 COLE BLVD |
Street Address 2 Of The Provider |
SUITE 150 |
City Of The Provider |
LAKEWOOD |
Zip Code Of The Provider |
804013208 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
153 |
Number Of Services |
5161 |
Number Of Medicare Beneficiaries |
3060 |
Total Submitted Charge Amount |
372101.6 |
Total Medicare Allowed Amount |
144358.34 |
Total Medicare Payment Amount |
108867.66 |
Total Medicare Standardized Payment Amount |
109892 |
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 |
153 |
Number Of Medical Services |
5161 |
Number Of Medicare Beneficiaries With Medical Services |
3060 |
Total Medical Submitted Charge Amount |
372101.6 |
Total Medical Medicare Allowed Amount |
144358.34 |
Total Medical Medicare Payment Amount |
108867.66 |
Total Medical Medicare Standardized Payment Amount |
109892 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
570 |
Number Of Beneficiaries Age 65 to 74 |
1192 |
Number Of Beneficiaries Age 75 to 84 |
810 |
Number Of Beneficiaries Age Greater 84 |
488 |
Number Of Female Beneficiaries |
1781 |
Number Of Male Beneficiaries |
1279 |
Number Of Non Hispanic White Beneficiaries |
2364 |
Number Of Black or African American Beneficiaries |
367 |
Number Of AsianPacific Islander Beneficiaries |
45 |
Number Of Hispanic Beneficiaries |
200 |
Number Of American Indian Alaska Native Beneficiaries |
16 |
Number Of Beneficiaries With Race Not Else where Classified |
68 |
Number Of Beneficiaries With Medicare Only Entitlement |
2301 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
759 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7989 |