National Provider Identifier [NPI]: |
1801003959 |
Last Name Of The Provider |
KIRK |
First Name Of The Provider |
CARISSA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2606 HOSPITAL BLVD |
Street Address 2 Of The Provider |
7TH FLOOR WEST |
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784051833 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
290 |
Number Of Medicare Beneficiaries |
123 |
Total Submitted Charge Amount |
301557 |
Total Medicare Allowed Amount |
107576.75 |
Total Medicare Payment Amount |
82132.62 |
Total Medicare Standardized Payment Amount |
89354.07 |
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 |
78 |
Number Of Medical Services |
290 |
Number Of Medicare Beneficiaries With Medical Services |
123 |
Total Medical Submitted Charge Amount |
301557 |
Total Medical Medicare Allowed Amount |
107576.75 |
Total Medical Medicare Payment Amount |
82132.62 |
Total Medical Medicare Standardized Payment Amount |
89354.07 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
66 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
32 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.3903 |