National Provider Identifier [NPI]: |
1700902764 |
Last Name Of The Provider |
GRIFFIN |
First Name Of The Provider |
SUSANNE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PSYD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7227 NORTH 16TH STREET |
Street Address 2 Of The Provider |
SUITE 219 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850205251 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
888 |
Number Of Medicare Beneficiaries |
294 |
Total Submitted Charge Amount |
176100 |
Total Medicare Allowed Amount |
84335.43 |
Total Medicare Payment Amount |
65847.83 |
Total Medicare Standardized Payment Amount |
51084.79 |
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 |
3 |
Number Of Medical Services |
888 |
Number Of Medicare Beneficiaries With Medical Services |
294 |
Total Medical Submitted Charge Amount |
176100 |
Total Medical Medicare Allowed Amount |
84335.43 |
Total Medical Medicare Payment Amount |
65847.83 |
Total Medical Medicare Standardized Payment Amount |
51084.79 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
149 |
Number Of Non Hispanic White Beneficiaries |
254 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
50 |
Average HCC Risk Score Of Beneficiaries |
2.0506 |