National Provider Identifier [NPI]: |
1881823581 |
Last Name Of The Provider |
PIWONKA |
First Name Of The Provider |
KYLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1725 E PROSPECT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT COLLINS |
Zip Code Of The Provider |
805251307 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
449 |
Number Of Medicare Beneficiaries |
215 |
Total Submitted Charge Amount |
162740 |
Total Medicare Allowed Amount |
61764.74 |
Total Medicare Payment Amount |
46772.9 |
Total Medicare Standardized Payment Amount |
48155.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
78 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
43465 |
Total Drug Medicare AllowedAmount |
29468.97 |
Total Drug Medicare PaymentAmount |
23067.69 |
Total Drug Medicare Standardized Payment Amount |
23067.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
371 |
Number Of Medicare Beneficiaries With Medical Services |
215 |
Total Medical Submitted Charge Amount |
119275 |
Total Medical Medicare Allowed Amount |
32295.77 |
Total Medical Medicare Payment Amount |
23705.21 |
Total Medical Medicare Standardized Payment Amount |
25088.22 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
166 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
69 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.3996 |