National Provider Identifier [NPI]: |
1962602482 |
Last Name Of The Provider |
KUYUMJIAN |
First Name Of The Provider |
EMIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3571 DEL PRADO BLVD N |
Street Address 2 Of The Provider |
SUITE 2 |
City Of The Provider |
CAPE CORAL |
Zip Code Of The Provider |
339095286 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
138 |
Number Of Services |
10883 |
Number Of Medicare Beneficiaries |
1164 |
Total Submitted Charge Amount |
1017389.5 |
Total Medicare Allowed Amount |
481862.44 |
Total Medicare Payment Amount |
351007.2 |
Total Medicare Standardized Payment Amount |
338867.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
4338 |
Number Of Medicare Beneficiaries With Drug Services |
219 |
Total Drug Submitted ChargeAmount |
41920.5 |
Total Drug Medicare AllowedAmount |
18883.92 |
Total Drug Medicare PaymentAmount |
15190.75 |
Total Drug Medicare Standardized Payment Amount |
15190.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
122 |
Number Of Medical Services |
6545 |
Number Of Medicare Beneficiaries With Medical Services |
1164 |
Total Medical Submitted Charge Amount |
975469 |
Total Medical Medicare Allowed Amount |
462978.52 |
Total Medical Medicare Payment Amount |
335816.45 |
Total Medical Medicare Standardized Payment Amount |
323676.56 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
576 |
Number Of Beneficiaries Age 75 to 84 |
370 |
Number Of Beneficiaries Age Greater 84 |
139 |
Number Of Female Beneficiaries |
635 |
Number Of Male Beneficiaries |
529 |
Number Of Non Hispanic White Beneficiaries |
1130 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1093 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0648 |