National Provider Identifier [NPI]: |
1962404186 |
Last Name Of The Provider |
KONDASH |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2841 BOUDINOT AVE |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452382496 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
3146 |
Number Of Medicare Beneficiaries |
1313 |
Total Submitted Charge Amount |
617443 |
Total Medicare Allowed Amount |
392986.79 |
Total Medicare Payment Amount |
282804.52 |
Total Medicare Standardized Payment Amount |
295815.52 |
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 |
36 |
Number Of Medical Services |
3146 |
Number Of Medicare Beneficiaries With Medical Services |
1313 |
Total Medical Submitted Charge Amount |
617443 |
Total Medical Medicare Allowed Amount |
392986.79 |
Total Medical Medicare Payment Amount |
282804.52 |
Total Medical Medicare Standardized Payment Amount |
295815.52 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
503 |
Number Of Beneficiaries Age 75 to 84 |
501 |
Number Of Beneficiaries Age Greater 84 |
256 |
Number Of Female Beneficiaries |
808 |
Number Of Male Beneficiaries |
505 |
Number Of Non Hispanic White Beneficiaries |
1254 |
Number Of Black or African American Beneficiaries |
19 |
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 |
29 |
Number Of Beneficiaries With Medicare Only Entitlement |
1262 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0509 |