National Provider Identifier [NPI]: |
1215993530 |
Last Name Of The Provider |
KORNAUS |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1821 S STOUGHTON RD |
Street Address 2 Of The Provider |
DEAN MEDICAL CENTER |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537162257 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
6315 |
Number Of Medicare Beneficiaries |
685 |
Total Submitted Charge Amount |
585747 |
Total Medicare Allowed Amount |
84715.79 |
Total Medicare Payment Amount |
52691.56 |
Total Medicare Standardized Payment Amount |
57303.39 |
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 |
18 |
Number Of Medical Services |
6315 |
Number Of Medicare Beneficiaries With Medical Services |
685 |
Total Medical Submitted Charge Amount |
585747 |
Total Medical Medicare Allowed Amount |
84715.79 |
Total Medical Medicare Payment Amount |
52691.56 |
Total Medical Medicare Standardized Payment Amount |
57303.39 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
403 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
406 |
Number Of Male Beneficiaries |
279 |
Number Of Non Hispanic White Beneficiaries |
648 |
Number Of Black or African American Beneficiaries |
|
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 |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
623 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.7951 |