National Provider Identifier [NPI]: |
1013948470 |
Last Name Of The Provider |
CARNEY |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
440 QUADRANGLE DR |
Street Address 2 Of The Provider |
SUITE G |
City Of The Provider |
BOLINGBROOK |
Zip Code Of The Provider |
604403454 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
537 |
Number Of Medicare Beneficiaries |
154 |
Total Submitted Charge Amount |
127267.9 |
Total Medicare Allowed Amount |
62359.02 |
Total Medicare Payment Amount |
39910.89 |
Total Medicare Standardized Payment Amount |
38052.93 |
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 |
7 |
Number Of Medical Services |
537 |
Number Of Medicare Beneficiaries With Medical Services |
154 |
Total Medical Submitted Charge Amount |
127267.9 |
Total Medical Medicare Allowed Amount |
62359.02 |
Total Medical Medicare Payment Amount |
39910.89 |
Total Medical Medicare Standardized Payment Amount |
38052.93 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
25 |
Number Of Black or African American Beneficiaries |
108 |
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 |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
28 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.4429 |