National Provider Identifier [NPI]: |
1366483919 |
Last Name Of The Provider |
LINDYBERG |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6701 N CHARLES ST |
Street Address 2 Of The Provider |
SUITE 4430 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212046808 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
497 |
Number Of Medicare Beneficiaries |
167 |
Total Submitted Charge Amount |
79800 |
Total Medicare Allowed Amount |
61678.32 |
Total Medicare Payment Amount |
47614.43 |
Total Medicare Standardized Payment Amount |
45188.52 |
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 |
7 |
Number Of Medical Services |
497 |
Number Of Medicare Beneficiaries With Medical Services |
167 |
Total Medical Submitted Charge Amount |
79800 |
Total Medical Medicare Allowed Amount |
61678.32 |
Total Medical Medicare Payment Amount |
47614.43 |
Total Medical Medicare Standardized Payment Amount |
45188.52 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
106 |
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 |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
48 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
2.6503 |