National Provider Identifier [NPI]: |
1891895934 |
Last Name Of The Provider |
KARAHODZIC |
First Name Of The Provider |
EDINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3915 WATSON RD |
Street Address 2 Of The Provider |
STE 203 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631091251 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
1785 |
Number Of Medicare Beneficiaries |
336 |
Total Submitted Charge Amount |
123423.08 |
Total Medicare Allowed Amount |
66808.47 |
Total Medicare Payment Amount |
46789.63 |
Total Medicare Standardized Payment Amount |
48026.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
796 |
Number Of Medicare Beneficiaries With Drug Services |
99 |
Total Drug Submitted ChargeAmount |
5655 |
Total Drug Medicare AllowedAmount |
588.79 |
Total Drug Medicare PaymentAmount |
471.38 |
Total Drug Medicare Standardized Payment Amount |
471.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
989 |
Number Of Medicare Beneficiaries With Medical Services |
336 |
Total Medical Submitted Charge Amount |
117768.08 |
Total Medical Medicare Allowed Amount |
66219.68 |
Total Medical Medicare Payment Amount |
46318.25 |
Total Medical Medicare Standardized Payment Amount |
47554.75 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
315 |
Number Of Black or African American Beneficiaries |
|
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 |
250 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0683 |