National Provider Identifier [NPI]: |
1336349141 |
Last Name Of The Provider |
SIEWERT |
First Name Of The Provider |
KYLE |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2200 FOREST RIDGE PKWY |
Street Address 2 Of The Provider |
SUITE 240 |
City Of The Provider |
NEW CASTLE |
Zip Code Of The Provider |
473622943 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
832 |
Number Of Medicare Beneficiaries |
221 |
Total Submitted Charge Amount |
362503 |
Total Medicare Allowed Amount |
95169.95 |
Total Medicare Payment Amount |
71814.73 |
Total Medicare Standardized Payment Amount |
75770.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
159 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
5065 |
Total Drug Medicare AllowedAmount |
3672.89 |
Total Drug Medicare PaymentAmount |
2855.88 |
Total Drug Medicare Standardized Payment Amount |
2855.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
84 |
Number Of Medical Services |
673 |
Number Of Medicare Beneficiaries With Medical Services |
221 |
Total Medical Submitted Charge Amount |
357438 |
Total Medical Medicare Allowed Amount |
91497.06 |
Total Medical Medicare Payment Amount |
68958.85 |
Total Medical Medicare Standardized Payment Amount |
72915.1 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1419 |