National Provider Identifier [NPI]: |
1295710556 |
Last Name Of The Provider |
KORTZ |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4570 ISABELLA INGRAM DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PENSACOLA |
Zip Code Of The Provider |
325045026 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
1660 |
Number Of Medicare Beneficiaries |
659 |
Total Submitted Charge Amount |
398780.63 |
Total Medicare Allowed Amount |
283999.99 |
Total Medicare Payment Amount |
208023.42 |
Total Medicare Standardized Payment Amount |
208464.71 |
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 |
68 |
Number Of Medical Services |
1660 |
Number Of Medicare Beneficiaries With Medical Services |
659 |
Total Medical Submitted Charge Amount |
398780.63 |
Total Medical Medicare Allowed Amount |
283999.99 |
Total Medical Medicare Payment Amount |
208023.42 |
Total Medical Medicare Standardized Payment Amount |
208464.71 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
287 |
Number Of Beneficiaries Age 75 to 84 |
213 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
383 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
548 |
Number Of Black or African American Beneficiaries |
78 |
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 |
534 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.107 |