National Provider Identifier [NPI]: |
1992790281 |
Last Name Of The Provider |
KWAKYE |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8205 E 56TH ST |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462161003 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
3556 |
Number Of Medicare Beneficiaries |
718 |
Total Submitted Charge Amount |
594185 |
Total Medicare Allowed Amount |
355597.81 |
Total Medicare Payment Amount |
267668.41 |
Total Medicare Standardized Payment Amount |
282426.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
912 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
29420 |
Total Drug Medicare AllowedAmount |
9664.57 |
Total Drug Medicare PaymentAmount |
7542.14 |
Total Drug Medicare Standardized Payment Amount |
7542.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
2644 |
Number Of Medicare Beneficiaries With Medical Services |
718 |
Total Medical Submitted Charge Amount |
564765 |
Total Medical Medicare Allowed Amount |
345933.24 |
Total Medical Medicare Payment Amount |
260126.27 |
Total Medical Medicare Standardized Payment Amount |
274884.42 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
209 |
Number Of Beneficiaries Age 65 to 74 |
234 |
Number Of Beneficiaries Age 75 to 84 |
200 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
349 |
Number Of Male Beneficiaries |
369 |
Number Of Non Hispanic White Beneficiaries |
448 |
Number Of Black or African American Beneficiaries |
251 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
448 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
270 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
4.7179 |