National Provider Identifier [NPI]: |
1548242118 |
Last Name Of The Provider |
KNOBLE |
First Name Of The Provider |
JEANNA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3100 PLAZA PROPERTIES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLOUMBUS |
Zip Code Of The Provider |
43219 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
160 |
Number Of Services |
51108 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
2989910 |
Total Medicare Allowed Amount |
963516.68 |
Total Medicare Payment Amount |
741851.98 |
Total Medicare Standardized Payment Amount |
750041.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
62 |
Number Of Drug Services |
46384 |
Number Of Medicare Beneficiaries With Drug Services |
120 |
Total Drug Submitted ChargeAmount |
2314152 |
Total Drug Medicare AllowedAmount |
766313.86 |
Total Drug Medicare PaymentAmount |
589700.83 |
Total Drug Medicare Standardized Payment Amount |
589700.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
98 |
Number Of Medical Services |
4724 |
Number Of Medicare Beneficiaries With Medical Services |
312 |
Total Medical Submitted Charge Amount |
675758 |
Total Medical Medicare Allowed Amount |
197202.82 |
Total Medical Medicare Payment Amount |
152151.15 |
Total Medical Medicare Standardized Payment Amount |
160340.77 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
269 |
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 |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
50 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.12 |