National Provider Identifier [NPI]: |
1932189123 |
Last Name Of The Provider |
NUKUNA |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 CONTINENTAL DR |
Street Address 2 Of The Provider |
SUITE 406 |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197134306 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
2455 |
Number Of Medicare Beneficiaries |
882 |
Total Submitted Charge Amount |
509787 |
Total Medicare Allowed Amount |
264871.26 |
Total Medicare Payment Amount |
206572 |
Total Medicare Standardized Payment Amount |
204066.61 |
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 |
2455 |
Number Of Medicare Beneficiaries With Medical Services |
882 |
Total Medical Submitted Charge Amount |
509787 |
Total Medical Medicare Allowed Amount |
264871.26 |
Total Medical Medicare Payment Amount |
206572 |
Total Medical Medicare Standardized Payment Amount |
204066.61 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
141 |
Number Of Beneficiaries Age 65 to 74 |
280 |
Number Of Beneficiaries Age 75 to 84 |
255 |
Number Of Beneficiaries Age Greater 84 |
206 |
Number Of Female Beneficiaries |
471 |
Number Of Male Beneficiaries |
411 |
Number Of Non Hispanic White Beneficiaries |
685 |
Number Of Black or African American Beneficiaries |
153 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
675 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.2921 |