National Provider Identifier [NPI]: |
1609806546 |
Last Name Of The Provider |
CARLSON |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2901 2ND AVE S |
Street Address 2 Of The Provider |
STE 270 |
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352332900 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
716 |
Number Of Medicare Beneficiaries |
571 |
Total Submitted Charge Amount |
696010 |
Total Medicare Allowed Amount |
72664.03 |
Total Medicare Payment Amount |
55652.35 |
Total Medicare Standardized Payment Amount |
59752.62 |
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 |
81 |
Number Of Medical Services |
716 |
Number Of Medicare Beneficiaries With Medical Services |
571 |
Total Medical Submitted Charge Amount |
696010 |
Total Medical Medicare Allowed Amount |
72664.03 |
Total Medical Medicare Payment Amount |
55652.35 |
Total Medical Medicare Standardized Payment Amount |
59752.62 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
270 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
339 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
506 |
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 |
507 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4211 |