National Provider Identifier [NPI]: |
1841263209 |
Last Name Of The Provider |
CORRAL |
First Name Of The Provider |
KENT |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4700 N HABANA AVE |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336147160 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
4413 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
392765.5 |
Total Medicare Allowed Amount |
305646.47 |
Total Medicare Payment Amount |
224107.76 |
Total Medicare Standardized Payment Amount |
226113.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
400 |
Number Of Medicare Beneficiaries With Drug Services |
207 |
Total Drug Submitted ChargeAmount |
11000.5 |
Total Drug Medicare AllowedAmount |
5356.55 |
Total Drug Medicare PaymentAmount |
5160.74 |
Total Drug Medicare Standardized Payment Amount |
5160.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
4013 |
Number Of Medicare Beneficiaries With Medical Services |
377 |
Total Medical Submitted Charge Amount |
381765 |
Total Medical Medicare Allowed Amount |
300289.92 |
Total Medical Medicare Payment Amount |
218947.02 |
Total Medical Medicare Standardized Payment Amount |
220953.01 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
202 |
Number Of Non Hispanic White Beneficiaries |
309 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0917 |