National Provider Identifier [NPI]: |
1073535019 |
Last Name Of The Provider |
BORGENICHT |
First Name Of The Provider |
KATHRYN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
905 HIGHLAND BLVD STE 4500 |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOZEMAN |
Zip Code Of The Provider |
597156903 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
882 |
Number Of Medicare Beneficiaries |
404 |
Total Submitted Charge Amount |
151604 |
Total Medicare Allowed Amount |
70300.83 |
Total Medicare Payment Amount |
48179.05 |
Total Medicare Standardized Payment Amount |
47937.69 |
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 |
25 |
Number Of Medical Services |
882 |
Number Of Medicare Beneficiaries With Medical Services |
404 |
Total Medical Submitted Charge Amount |
151604 |
Total Medical Medicare Allowed Amount |
70300.83 |
Total Medical Medicare Payment Amount |
48179.05 |
Total Medical Medicare Standardized Payment Amount |
47937.69 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
290 |
Number Of Male Beneficiaries |
114 |
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 |
341 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
19 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3047 |