National Provider Identifier [NPI]: |
1487669917 |
Last Name Of The Provider |
POWAZEK |
First Name Of The Provider |
MORRIS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1015 N FIRST AVE |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
ARCADIA |
Zip Code Of The Provider |
910067401 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
604 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
64080 |
Total Medicare Allowed Amount |
50647.35 |
Total Medicare Payment Amount |
38457.71 |
Total Medicare Standardized Payment Amount |
25460.28 |
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 |
8 |
Number Of Medical Services |
604 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
64080 |
Total Medical Medicare Allowed Amount |
50647.35 |
Total Medical Medicare Payment Amount |
38457.71 |
Total Medical Medicare Standardized Payment Amount |
25460.28 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
105 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
114 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
44 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
33 |
Average HCC Risk Score Of Beneficiaries |
2.1238 |