National Provider Identifier [NPI]: |
1821198490 |
Last Name Of The Provider |
KOLETTIS |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
660 GLADES RD |
Street Address 2 Of The Provider |
SUITE 460 |
City Of The Provider |
BOCA RATON |
Zip Code Of The Provider |
334316465 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
8495 |
Number Of Medicare Beneficiaries |
1350 |
Total Submitted Charge Amount |
1593099.41 |
Total Medicare Allowed Amount |
516486.05 |
Total Medicare Payment Amount |
380595.07 |
Total Medicare Standardized Payment Amount |
364184.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
1766 |
Number Of Medicare Beneficiaries With Drug Services |
525 |
Total Drug Submitted ChargeAmount |
92443.08 |
Total Drug Medicare AllowedAmount |
30354.31 |
Total Drug Medicare PaymentAmount |
23481.34 |
Total Drug Medicare Standardized Payment Amount |
23481.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
95 |
Number Of Medical Services |
6729 |
Number Of Medicare Beneficiaries With Medical Services |
1350 |
Total Medical Submitted Charge Amount |
1500656.33 |
Total Medical Medicare Allowed Amount |
486131.74 |
Total Medical Medicare Payment Amount |
357113.73 |
Total Medical Medicare Standardized Payment Amount |
340702.81 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
562 |
Number Of Beneficiaries Age 75 to 84 |
495 |
Number Of Beneficiaries Age Greater 84 |
258 |
Number Of Female Beneficiaries |
823 |
Number Of Male Beneficiaries |
527 |
Number Of Non Hispanic White Beneficiaries |
1293 |
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 |
25 |
Number Of Beneficiaries With Medicare Only Entitlement |
1325 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.118 |