National Provider Identifier [NPI]: |
1063522266 |
Last Name Of The Provider |
KENIK |
First Name Of The Provider |
JAY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
601 N 30TH ST STE 5700 |
Street Address 2 Of The Provider |
|
City Of The Provider |
OMAHA |
Zip Code Of The Provider |
681312137 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
16632 |
Number Of Medicare Beneficiaries |
808 |
Total Submitted Charge Amount |
475608.5 |
Total Medicare Allowed Amount |
210758.26 |
Total Medicare Payment Amount |
152203.44 |
Total Medicare Standardized Payment Amount |
158444.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
2907 |
Number Of Medicare Beneficiaries With Drug Services |
110 |
Total Drug Submitted ChargeAmount |
61738.5 |
Total Drug Medicare AllowedAmount |
29135.71 |
Total Drug Medicare PaymentAmount |
22191.1 |
Total Drug Medicare Standardized Payment Amount |
22191.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
13725 |
Number Of Medicare Beneficiaries With Medical Services |
808 |
Total Medical Submitted Charge Amount |
413870 |
Total Medical Medicare Allowed Amount |
181622.55 |
Total Medical Medicare Payment Amount |
130012.34 |
Total Medical Medicare Standardized Payment Amount |
136253.04 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
188 |
Number Of Beneficiaries Age 65 to 74 |
325 |
Number Of Beneficiaries Age 75 to 84 |
220 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
584 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
735 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
630 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
178 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2017 |