National Provider Identifier [NPI]: |
1982753968 |
Last Name Of The Provider |
KURITA |
First Name Of The Provider |
STEPHANIE |
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 |
3601 TVC |
Street Address 2 Of The Provider |
|
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372320001 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
877 |
Number Of Medicare Beneficiaries |
454 |
Total Submitted Charge Amount |
243243 |
Total Medicare Allowed Amount |
70975.57 |
Total Medicare Payment Amount |
59411.32 |
Total Medicare Standardized Payment Amount |
65852.65 |
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 |
32 |
Number Of Medical Services |
877 |
Number Of Medicare Beneficiaries With Medical Services |
454 |
Total Medical Submitted Charge Amount |
243243 |
Total Medical Medicare Allowed Amount |
70975.57 |
Total Medical Medicare Payment Amount |
59411.32 |
Total Medical Medicare Standardized Payment Amount |
65852.65 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
265 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
414 |
Number Of Male Beneficiaries |
40 |
Number Of Non Hispanic White Beneficiaries |
388 |
Number Of Black or African American Beneficiaries |
53 |
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 |
400 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
2 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1206 |