National Provider Identifier [NPI]: |
1558675611 |
Last Name Of The Provider |
ALLEN |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPT |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5 PEQUOT PARK RD |
Street Address 2 Of The Provider |
SUITE 303 |
City Of The Provider |
WESTBROOK |
Zip Code Of The Provider |
064982856 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
4486 |
Number Of Medicare Beneficiaries |
140 |
Total Submitted Charge Amount |
283955 |
Total Medicare Allowed Amount |
120575.32 |
Total Medicare Payment Amount |
92025.83 |
Total Medicare Standardized Payment Amount |
69585.98 |
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 |
12 |
Number Of Medical Services |
4486 |
Number Of Medicare Beneficiaries With Medical Services |
140 |
Total Medical Submitted Charge Amount |
283955 |
Total Medical Medicare Allowed Amount |
120575.32 |
Total Medical Medicare Payment Amount |
92025.83 |
Total Medical Medicare Standardized Payment Amount |
69585.98 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0148 |