| National Provider Identifier [NPI]: | 1093812877 |
| Last Name Of The Provider | KORTBEIN |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | P.A.-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5000 W CHAMBERS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532101650 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 279 |
| Number Of Medicare Beneficiaries | 214 |
| Total Submitted Charge Amount | 136191 |
| Total Medicare Allowed Amount | 22334.03 |
| Total Medicare Payment Amount | 16262.92 |
| Total Medicare Standardized Payment Amount | 20221.16 |
| 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 | 24 |
| Number Of Medical Services | 279 |
| Number Of Medicare Beneficiaries With Medical Services | 214 |
| Total Medical Submitted Charge Amount | 136191 |
| Total Medical Medicare Allowed Amount | 22334.03 |
| Total Medical Medicare Payment Amount | 16262.92 |
| Total Medical Medicare Standardized Payment Amount | 20221.16 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | 114 |
| Number Of Black or African American Beneficiaries | 84 |
| 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 | 95 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6733 |