National Provider Identifier [NPI]: |
1255432134 |
Last Name Of The Provider |
KENZER |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10400 75TH ST |
Street Address 2 Of The Provider |
SUITE 215 |
City Of The Provider |
KENOSHA |
Zip Code Of The Provider |
531427884 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
12968 |
Number Of Medicare Beneficiaries |
612 |
Total Submitted Charge Amount |
1026689.36 |
Total Medicare Allowed Amount |
300963.69 |
Total Medicare Payment Amount |
221036.71 |
Total Medicare Standardized Payment Amount |
226383.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
10276 |
Number Of Medicare Beneficiaries With Drug Services |
246 |
Total Drug Submitted ChargeAmount |
232034.36 |
Total Drug Medicare AllowedAmount |
112192.43 |
Total Drug Medicare PaymentAmount |
86730.37 |
Total Drug Medicare Standardized Payment Amount |
86730.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
2692 |
Number Of Medicare Beneficiaries With Medical Services |
612 |
Total Medical Submitted Charge Amount |
794655 |
Total Medical Medicare Allowed Amount |
188771.26 |
Total Medical Medicare Payment Amount |
134306.34 |
Total Medical Medicare Standardized Payment Amount |
139653.3 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
150 |
Number Of Beneficiaries Age 65 to 74 |
228 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
431 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
524 |
Number Of Black or African American Beneficiaries |
45 |
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 |
478 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2612 |