National Provider Identifier [NPI]: |
1316038789 |
Last Name Of The Provider |
KISSEL |
First Name Of The Provider |
STEVE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1148 INDIANAPOLIS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENCASTLE |
Zip Code Of The Provider |
46135 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1492 |
Number Of Medicare Beneficiaries |
323 |
Total Submitted Charge Amount |
145779 |
Total Medicare Allowed Amount |
133789.82 |
Total Medicare Payment Amount |
97504.73 |
Total Medicare Standardized Payment Amount |
103650.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
360 |
Total Drug Medicare AllowedAmount |
216.72 |
Total Drug Medicare PaymentAmount |
212.4 |
Total Drug Medicare Standardized Payment Amount |
212.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
1474 |
Number Of Medicare Beneficiaries With Medical Services |
323 |
Total Medical Submitted Charge Amount |
145419 |
Total Medical Medicare Allowed Amount |
133573.1 |
Total Medical Medicare Payment Amount |
97292.33 |
Total Medical Medicare Standardized Payment Amount |
103437.79 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4444 |