National Provider Identifier [NPI]: |
1316909864 |
Last Name Of The Provider |
KANTOR |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2425 N LAMB BLVD |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891155420 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
12120 |
Number Of Medicare Beneficiaries |
604 |
Total Submitted Charge Amount |
676167 |
Total Medicare Allowed Amount |
337981.6 |
Total Medicare Payment Amount |
253196.93 |
Total Medicare Standardized Payment Amount |
248748.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
9815 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
19725 |
Total Drug Medicare AllowedAmount |
8903.75 |
Total Drug Medicare PaymentAmount |
6863.13 |
Total Drug Medicare Standardized Payment Amount |
6863.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
2305 |
Number Of Medicare Beneficiaries With Medical Services |
604 |
Total Medical Submitted Charge Amount |
656442 |
Total Medical Medicare Allowed Amount |
329077.85 |
Total Medical Medicare Payment Amount |
246333.8 |
Total Medical Medicare Standardized Payment Amount |
241885.85 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
194 |
Number Of Beneficiaries Age 65 to 74 |
195 |
Number Of Beneficiaries Age 75 to 84 |
155 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
290 |
Number Of Male Beneficiaries |
314 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
142 |
Number Of AsianPacific Islander Beneficiaries |
53 |
Number Of Hispanic Beneficiaries |
116 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
417 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
69 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
4.4769 |