National Provider Identifier [NPI]: |
1821035973 |
Last Name Of The Provider |
TOOTLE |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5504 GATEWAY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WESLEY CHAPEL |
Zip Code Of The Provider |
335441900 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
297 |
Number Of Medicare Beneficiaries |
164 |
Total Submitted Charge Amount |
63234 |
Total Medicare Allowed Amount |
21203.59 |
Total Medicare Payment Amount |
12030.5 |
Total Medicare Standardized Payment Amount |
12422.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
453 |
Total Drug Medicare AllowedAmount |
52.47 |
Total Drug Medicare PaymentAmount |
4.52 |
Total Drug Medicare Standardized Payment Amount |
4.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
245 |
Number Of Medicare Beneficiaries With Medical Services |
164 |
Total Medical Submitted Charge Amount |
62781 |
Total Medical Medicare Allowed Amount |
21151.12 |
Total Medical Medicare Payment Amount |
12025.98 |
Total Medical Medicare Standardized Payment Amount |
12418.44 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
142 |
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 |
153 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9646 |