National Provider Identifier [NPI]: |
1407823271 |
Last Name Of The Provider |
BARTOO |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
PT |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1875 N LAKEWOOD DR |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
COEUR DALENE |
Zip Code Of The Provider |
838144928 |
State Code Of The Provider |
ID |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
2818 |
Number Of Medicare Beneficiaries |
126 |
Total Submitted Charge Amount |
118434 |
Total Medicare Allowed Amount |
75724.09 |
Total Medicare Payment Amount |
57247.51 |
Total Medicare Standardized Payment Amount |
48081.98 |
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 |
9 |
Number Of Medical Services |
2818 |
Number Of Medicare Beneficiaries With Medical Services |
126 |
Total Medical Submitted Charge Amount |
118434 |
Total Medical Medicare Allowed Amount |
75724.09 |
Total Medical Medicare Payment Amount |
57247.51 |
Total Medical Medicare Standardized Payment Amount |
48081.98 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
65 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8315 |