National Provider Identifier [NPI]: |
1114934270 |
Last Name Of The Provider |
KNEE |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 ALBANY TURNPIKE |
Street Address 2 Of The Provider |
CANTON GATEWAY PARK BUILDING 5 |
City Of The Provider |
CANTON |
Zip Code Of The Provider |
06019 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
1 |
Number Of Services |
541 |
Number Of Medicare Beneficiaries |
72 |
Total Submitted Charge Amount |
64920 |
Total Medicare Allowed Amount |
45767 |
Total Medicare Payment Amount |
35761.48 |
Total Medicare Standardized Payment Amount |
25446 |
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 |
1 |
Number Of Medical Services |
541 |
Number Of Medicare Beneficiaries With Medical Services |
72 |
Total Medical Submitted Charge Amount |
64920 |
Total Medical Medicare Allowed Amount |
45767 |
Total Medical Medicare Payment Amount |
35761.48 |
Total Medical Medicare Standardized Payment Amount |
25446 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
17 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
33 |
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 |
41 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
53 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.1739 |