| National Provider Identifier [NPI]: | 1568436392 |
| Last Name Of The Provider | KORMYLO |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 285 SILLS RD |
| Street Address 2 Of The Provider | BLDG. 5-6 #H |
| City Of The Provider | EAST PATCHOGUE |
| Zip Code Of The Provider | 117724869 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 5006 |
| Number Of Medicare Beneficiaries | 1003 |
| Total Submitted Charge Amount | 523637.82 |
| Total Medicare Allowed Amount | 405060.55 |
| Total Medicare Payment Amount | 303117.38 |
| Total Medicare Standardized Payment Amount | 264720.6 |
| 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 | 90 |
| Number Of Medical Services | 5006 |
| Number Of Medicare Beneficiaries With Medical Services | 1003 |
| Total Medical Submitted Charge Amount | 523637.82 |
| Total Medical Medicare Allowed Amount | 405060.55 |
| Total Medical Medicare Payment Amount | 303117.38 |
| Total Medical Medicare Standardized Payment Amount | 264720.6 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 357 |
| Number Of Beneficiaries Age 75 to 84 | 295 |
| Number Of Beneficiaries Age Greater 84 | 220 |
| Number Of Female Beneficiaries | 604 |
| Number Of Male Beneficiaries | 399 |
| Number Of Non Hispanic White Beneficiaries | 890 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 770 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 233 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8596 |