National Provider Identifier [NPI]: |
1366536427 |
Last Name Of The Provider |
KRANK |
First Name Of The Provider |
KELVIN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 GROVE RD |
Street Address 2 Of The Provider |
5TH FLOOR |
City Of The Provider |
GREENVILLE |
Zip Code Of The Provider |
296054210 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
329 |
Number Of Medicare Beneficiaries |
108 |
Total Submitted Charge Amount |
60541.2 |
Total Medicare Allowed Amount |
27685.84 |
Total Medicare Payment Amount |
21341.44 |
Total Medicare Standardized Payment Amount |
22745.41 |
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 |
12 |
Number Of Medical Services |
329 |
Number Of Medicare Beneficiaries With Medical Services |
108 |
Total Medical Submitted Charge Amount |
60541.2 |
Total Medical Medicare Allowed Amount |
27685.84 |
Total Medical Medicare Payment Amount |
21341.44 |
Total Medical Medicare Standardized Payment Amount |
22745.41 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
63 |
Number Of Male Beneficiaries |
45 |
Number Of Non Hispanic White Beneficiaries |
87 |
Number Of Black or African American Beneficiaries |
|
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 |
64 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2812 |