National Provider Identifier [NPI]: |
1801885017 |
Last Name Of The Provider |
KELSCH |
First Name Of The Provider |
TIMOTHY |
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 |
3501 N SCOTTSDALE RD #160 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
85251 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
98 |
Number Of Services |
2308 |
Number Of Medicare Beneficiaries |
665 |
Total Submitted Charge Amount |
848917.95 |
Total Medicare Allowed Amount |
329373.79 |
Total Medicare Payment Amount |
247030.83 |
Total Medicare Standardized Payment Amount |
238294.2 |
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 |
98 |
Number Of Medical Services |
2308 |
Number Of Medicare Beneficiaries With Medical Services |
665 |
Total Medical Submitted Charge Amount |
848917.95 |
Total Medical Medicare Allowed Amount |
329373.79 |
Total Medical Medicare Payment Amount |
247030.83 |
Total Medical Medicare Standardized Payment Amount |
238294.2 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
310 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
290 |
Number Of Non Hispanic White Beneficiaries |
632 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
642 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0339 |