National Provider Identifier [NPI]: |
1548335714 |
Last Name Of The Provider |
HUFNER |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
LCSW |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20 RESEARCH PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
OLD SAYBROOK |
Zip Code Of The Provider |
064754214 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Licensed Clinical Social Worker |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
823 |
Number Of Medicare Beneficiaries |
117 |
Total Submitted Charge Amount |
127113 |
Total Medicare Allowed Amount |
56678.85 |
Total Medicare Payment Amount |
41655.78 |
Total Medicare Standardized Payment Amount |
39912.74 |
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 |
6 |
Number Of Medical Services |
823 |
Number Of Medicare Beneficiaries With Medical Services |
117 |
Total Medical Submitted Charge Amount |
127113 |
Total Medical Medicare Allowed Amount |
56678.85 |
Total Medical Medicare Payment Amount |
41655.78 |
Total Medical Medicare Standardized Payment Amount |
39912.74 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
17 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
29 |
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 |
38 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
27 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.3198 |