National Provider Identifier [NPI]: |
1104052919 |
Last Name Of The Provider |
KONOR |
First Name Of The Provider |
LINDSEY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1107 E 66TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAVANNAH |
Zip Code Of The Provider |
314045701 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
989 |
Number Of Medicare Beneficiaries |
266 |
Total Submitted Charge Amount |
107734 |
Total Medicare Allowed Amount |
55023.27 |
Total Medicare Payment Amount |
41276.6 |
Total Medicare Standardized Payment Amount |
43109.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
2943 |
Total Drug Medicare AllowedAmount |
1802.53 |
Total Drug Medicare PaymentAmount |
1766.3 |
Total Drug Medicare Standardized Payment Amount |
1766.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
951 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
104791 |
Total Medical Medicare Allowed Amount |
53220.74 |
Total Medical Medicare Payment Amount |
39510.3 |
Total Medical Medicare Standardized Payment Amount |
41342.88 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
166 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
102 |
Number Of Black or African American Beneficiaries |
147 |
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 |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6497 |