National Provider Identifier [NPI]: |
1407830888 |
Last Name Of The Provider |
KIENZLE |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421009 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
765 |
Number Of Medicare Beneficiaries |
525 |
Total Submitted Charge Amount |
166180 |
Total Medicare Allowed Amount |
38893.84 |
Total Medicare Payment Amount |
27867.98 |
Total Medicare Standardized Payment Amount |
30075.56 |
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 |
17 |
Number Of Medical Services |
765 |
Number Of Medicare Beneficiaries With Medical Services |
525 |
Total Medical Submitted Charge Amount |
166180 |
Total Medical Medicare Allowed Amount |
38893.84 |
Total Medical Medicare Payment Amount |
27867.98 |
Total Medical Medicare Standardized Payment Amount |
30075.56 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
202 |
Number Of Beneficiaries Age 75 to 84 |
162 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
255 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
499 |
Number Of Black or African American Beneficiaries |
14 |
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 |
402 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5145 |