National Provider Identifier [NPI]: |
1336135276 |
Last Name Of The Provider |
KOLB |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1505 SOUTHWEST BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
JEFFERSON CITY |
Zip Code Of The Provider |
651092431 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
7294 |
Number Of Medicare Beneficiaries |
544 |
Total Submitted Charge Amount |
465058 |
Total Medicare Allowed Amount |
221781.26 |
Total Medicare Payment Amount |
165324.13 |
Total Medicare Standardized Payment Amount |
176234.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
3875 |
Number Of Medicare Beneficiaries With Drug Services |
91 |
Total Drug Submitted ChargeAmount |
47308 |
Total Drug Medicare AllowedAmount |
25655.3 |
Total Drug Medicare PaymentAmount |
20673.33 |
Total Drug Medicare Standardized Payment Amount |
20673.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
60 |
Number Of Medical Services |
3419 |
Number Of Medicare Beneficiaries With Medical Services |
544 |
Total Medical Submitted Charge Amount |
417750 |
Total Medical Medicare Allowed Amount |
196125.96 |
Total Medical Medicare Payment Amount |
144650.8 |
Total Medical Medicare Standardized Payment Amount |
155561.66 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
180 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
330 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
514 |
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 |
444 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.6654 |