National Provider Identifier [NPI]: |
1942240973 |
Last Name Of The Provider |
KENNEALY |
First Name Of The Provider |
JAMES |
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 |
2001 ANDERSON FERRY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452383325 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
945 |
Number Of Medicare Beneficiaries |
365 |
Total Submitted Charge Amount |
98285 |
Total Medicare Allowed Amount |
62112.07 |
Total Medicare Payment Amount |
43608.37 |
Total Medicare Standardized Payment Amount |
45743.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
3651 |
Total Drug Medicare AllowedAmount |
2588.89 |
Total Drug Medicare PaymentAmount |
2537.08 |
Total Drug Medicare Standardized Payment Amount |
2537.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
906 |
Number Of Medicare Beneficiaries With Medical Services |
365 |
Total Medical Submitted Charge Amount |
94634 |
Total Medical Medicare Allowed Amount |
59523.18 |
Total Medical Medicare Payment Amount |
41071.29 |
Total Medical Medicare Standardized Payment Amount |
43206.51 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
168 |
Number Of Non Hispanic White Beneficiaries |
331 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
31 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
55 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6496 |