National Provider Identifier [NPI]: |
1326066747 |
Last Name Of The Provider |
KORENBLAT |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4570 CHILDRENS PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101020 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1432 |
Number Of Medicare Beneficiaries |
590 |
Total Submitted Charge Amount |
408863 |
Total Medicare Allowed Amount |
113988.39 |
Total Medicare Payment Amount |
84246.31 |
Total Medicare Standardized Payment Amount |
86115.08 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
279 |
Number Of Beneficiaries Age 65 to 74 |
225 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
275 |
Number Of Male Beneficiaries |
315 |
Number Of Non Hispanic White Beneficiaries |
444 |
Number Of Black or African American Beneficiaries |
126 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
223 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
2.6273 |