National Provider Identifier [NPI]: |
1932138146 |
Last Name Of The Provider |
KAHL |
First Name Of The Provider |
JAKUB |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3001 W DR MARTIN LUTHER KING JR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336076307 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1039 |
Number Of Medicare Beneficiaries |
720 |
Total Submitted Charge Amount |
610100 |
Total Medicare Allowed Amount |
115552.28 |
Total Medicare Payment Amount |
89257.16 |
Total Medicare Standardized Payment Amount |
87815.43 |
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 |
14 |
Number Of Medical Services |
1039 |
Number Of Medicare Beneficiaries With Medical Services |
720 |
Total Medical Submitted Charge Amount |
610100 |
Total Medical Medicare Allowed Amount |
115552.28 |
Total Medical Medicare Payment Amount |
89257.16 |
Total Medical Medicare Standardized Payment Amount |
87815.43 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
280 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
437 |
Number Of Male Beneficiaries |
283 |
Number Of Non Hispanic White Beneficiaries |
341 |
Number Of Black or African American Beneficiaries |
150 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
207 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
298 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
422 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.1383 |