National Provider Identifier [NPI]: |
1134346539 |
Last Name Of The Provider |
KOCONIS |
First Name Of The Provider |
KRISTEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 UNIVERSITY DR |
Street Address 2 Of The Provider |
H088 |
City Of The Provider |
HERSHEY |
Zip Code Of The Provider |
170332360 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
2634 |
Number Of Medicare Beneficiaries |
1201 |
Total Submitted Charge Amount |
373750 |
Total Medicare Allowed Amount |
74603.3 |
Total Medicare Payment Amount |
64460.97 |
Total Medicare Standardized Payment Amount |
66279.87 |
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 |
24 |
Number Of Medical Services |
2634 |
Number Of Medicare Beneficiaries With Medical Services |
1201 |
Total Medical Submitted Charge Amount |
373750 |
Total Medical Medicare Allowed Amount |
74603.3 |
Total Medical Medicare Payment Amount |
64460.97 |
Total Medical Medicare Standardized Payment Amount |
66279.87 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
214 |
Number Of Beneficiaries Age 65 to 74 |
698 |
Number Of Beneficiaries Age 75 to 84 |
246 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
1162 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
975 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
226 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9681 |