National Provider Identifier [NPI]: |
1942290044 |
Last Name Of The Provider |
KRAFT |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1150 GRAHAM RD |
Street Address 2 Of The Provider |
STE 107 |
City Of The Provider |
FLORISSANT |
Zip Code Of The Provider |
630318077 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1260 |
Number Of Medicare Beneficiaries |
751 |
Total Submitted Charge Amount |
204270 |
Total Medicare Allowed Amount |
136273.53 |
Total Medicare Payment Amount |
92840.46 |
Total Medicare Standardized Payment Amount |
95803.26 |
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 |
21 |
Number Of Medical Services |
1260 |
Number Of Medicare Beneficiaries With Medical Services |
751 |
Total Medical Submitted Charge Amount |
204270 |
Total Medical Medicare Allowed Amount |
136273.53 |
Total Medical Medicare Payment Amount |
92840.46 |
Total Medical Medicare Standardized Payment Amount |
95803.26 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
284 |
Number Of Beneficiaries Age 75 to 84 |
262 |
Number Of Beneficiaries Age Greater 84 |
122 |
Number Of Female Beneficiaries |
481 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
469 |
Number Of Black or African American Beneficiaries |
268 |
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 |
660 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2861 |