National Provider Identifier [NPI]: |
1144248436 |
Last Name Of The Provider |
KRUEGER |
First Name Of The Provider |
NANCY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
590 S MAGNOLIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EL CAJON |
Zip Code Of The Provider |
920206011 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
7628 |
Number Of Medicare Beneficiaries |
145 |
Total Submitted Charge Amount |
280086 |
Total Medicare Allowed Amount |
187536.44 |
Total Medicare Payment Amount |
144641.91 |
Total Medicare Standardized Payment Amount |
86440.21 |
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 |
11 |
Number Of Medical Services |
7628 |
Number Of Medicare Beneficiaries With Medical Services |
145 |
Total Medical Submitted Charge Amount |
280086 |
Total Medical Medicare Allowed Amount |
187536.44 |
Total Medical Medicare Payment Amount |
144641.91 |
Total Medical Medicare Standardized Payment Amount |
86440.21 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
117 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
87 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1676 |