National Provider Identifier [NPI]: |
1134152655 |
Last Name Of The Provider |
MONSON |
First Name Of The Provider |
EILEEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PHD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 SW 2ND AVE |
Street Address 2 Of The Provider |
#101 |
City Of The Provider |
BOCA RATON |
Zip Code Of The Provider |
334325991 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
1055 |
Number Of Medicare Beneficiaries |
74 |
Total Submitted Charge Amount |
188275 |
Total Medicare Allowed Amount |
112371.69 |
Total Medicare Payment Amount |
86161.12 |
Total Medicare Standardized Payment Amount |
83588.64 |
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 |
3 |
Number Of Medical Services |
1055 |
Number Of Medicare Beneficiaries With Medical Services |
74 |
Total Medical Submitted Charge Amount |
188275 |
Total Medical Medicare Allowed Amount |
112371.69 |
Total Medical Medicare Payment Amount |
86161.12 |
Total Medical Medicare Standardized Payment Amount |
83588.64 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
56 |
Number Of Male Beneficiaries |
18 |
Number Of Non Hispanic White Beneficiaries |
74 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
62 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3223 |