National Provider Identifier [NPI]: |
1720083306 |
Last Name Of The Provider |
KOENIG |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 E 40TH ST |
Street Address 2 Of The Provider |
RM 203 |
City Of The Provider |
NEW YORK |
Zip Code Of The Provider |
100161201 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1459 |
Number Of Medicare Beneficiaries |
351 |
Total Submitted Charge Amount |
71280.39 |
Total Medicare Allowed Amount |
63952.59 |
Total Medicare Payment Amount |
37537.47 |
Total Medicare Standardized Payment Amount |
35074.58 |
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 |
18 |
Number Of Medical Services |
1459 |
Number Of Medicare Beneficiaries With Medical Services |
351 |
Total Medical Submitted Charge Amount |
71280.39 |
Total Medical Medicare Allowed Amount |
63952.59 |
Total Medical Medicare Payment Amount |
37537.47 |
Total Medical Medicare Standardized Payment Amount |
35074.58 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
174 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
141 |
Number Of Non Hispanic White Beneficiaries |
268 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
298 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0029 |