National Provider Identifier [NPI]: |
1023001518 |
Last Name Of The Provider |
KYNCL |
First Name Of The Provider |
JOHN |
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 |
700 S LEWIS AVE |
Street Address 2 Of The Provider |
#210 |
City Of The Provider |
WAUKEGAN |
Zip Code Of The Provider |
600856100 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1428 |
Number Of Medicare Beneficiaries |
216 |
Total Submitted Charge Amount |
255590 |
Total Medicare Allowed Amount |
114743.52 |
Total Medicare Payment Amount |
84167.87 |
Total Medicare Standardized Payment Amount |
79266.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
505 |
Total Drug Medicare AllowedAmount |
215.76 |
Total Drug Medicare PaymentAmount |
208.89 |
Total Drug Medicare Standardized Payment Amount |
208.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
1412 |
Number Of Medicare Beneficiaries With Medical Services |
216 |
Total Medical Submitted Charge Amount |
255085 |
Total Medical Medicare Allowed Amount |
114527.76 |
Total Medical Medicare Payment Amount |
83958.98 |
Total Medical Medicare Standardized Payment Amount |
79057.52 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
128 |
Number Of Black or African American Beneficiaries |
55 |
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 |
132 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7684 |