National Provider Identifier [NPI]: |
1124089115 |
Last Name Of The Provider |
KRAFT |
First Name Of The Provider |
KURT |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 W MAPLE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GENEVA |
Zip Code Of The Provider |
363401609 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
7019 |
Number Of Medicare Beneficiaries |
432 |
Total Submitted Charge Amount |
357856.5 |
Total Medicare Allowed Amount |
246707.14 |
Total Medicare Payment Amount |
169658.35 |
Total Medicare Standardized Payment Amount |
187104.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
2772 |
Number Of Medicare Beneficiaries With Drug Services |
193 |
Total Drug Submitted ChargeAmount |
47497.5 |
Total Drug Medicare AllowedAmount |
4571.88 |
Total Drug Medicare PaymentAmount |
3824.64 |
Total Drug Medicare Standardized Payment Amount |
3824.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
87 |
Number Of Medical Services |
4247 |
Number Of Medicare Beneficiaries With Medical Services |
432 |
Total Medical Submitted Charge Amount |
310359 |
Total Medical Medicare Allowed Amount |
242135.26 |
Total Medical Medicare Payment Amount |
165833.71 |
Total Medical Medicare Standardized Payment Amount |
183279.72 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
237 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
398 |
Number Of Black or African American Beneficiaries |
|
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 |
285 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1009 |