| National Provider Identifier [NPI]: | 1609872266 |
| Last Name Of The Provider | KORNBLUTH |
| First Name Of The Provider | IRA |
| 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 | 7920 MCDONOGH RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | OWINGS MILLS |
| Zip Code Of The Provider | 211175273 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 2515 |
| Number Of Medicare Beneficiaries | 867 |
| Total Submitted Charge Amount | 539351.36 |
| Total Medicare Allowed Amount | 226121.28 |
| Total Medicare Payment Amount | 164593.02 |
| Total Medicare Standardized Payment Amount | 158922.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 6052.82 |
| Total Drug Medicare AllowedAmount | 3641.14 |
| Total Drug Medicare PaymentAmount | 2847.24 |
| Total Drug Medicare Standardized Payment Amount | 2847.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 2379 |
| Number Of Medicare Beneficiaries With Medical Services | 867 |
| Total Medical Submitted Charge Amount | 533298.54 |
| Total Medical Medicare Allowed Amount | 222480.14 |
| Total Medical Medicare Payment Amount | 161745.78 |
| Total Medical Medicare Standardized Payment Amount | 156075.71 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 466 |
| Number Of Beneficiaries Age 65 to 74 | 264 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 547 |
| Number Of Male Beneficiaries | 320 |
| Number Of Non Hispanic White Beneficiaries | 612 |
| Number Of Black or African American Beneficiaries | 229 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 503 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 364 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4231 |