National Provider Identifier [NPI]: |
1962624189 |
Last Name Of The Provider |
KENOSI |
First Name Of The Provider |
THABO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 HOUGHTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAGINAW |
Zip Code Of The Provider |
486025303 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
413 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
47629 |
Total Medicare Allowed Amount |
34947.44 |
Total Medicare Payment Amount |
23463.72 |
Total Medicare Standardized Payment Amount |
25432.4 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
133 |
Number Of Black or African American Beneficiaries |
23 |
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 |
110 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3503 |