National Provider Identifier [NPI]: |
1871689422 |
Last Name Of The Provider |
KOVALOVICH |
First Name Of The Provider |
KELLEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
420 W. LINFIELD TRAPPE ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHOENIXVILLE |
Zip Code Of The Provider |
19460 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1296 |
Number Of Medicare Beneficiaries |
631 |
Total Submitted Charge Amount |
416634 |
Total Medicare Allowed Amount |
208127.31 |
Total Medicare Payment Amount |
160981.5 |
Total Medicare Standardized Payment Amount |
151563 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
325 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
331 |
Number Of Male Beneficiaries |
300 |
Number Of Non Hispanic White Beneficiaries |
590 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
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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 |
531 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5237 |