National Provider Identifier [NPI]: |
1043521396 |
Last Name Of The Provider |
HUTMAN |
First Name Of The Provider |
NATALLIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MSPT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
564 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WALTHAM |
Zip Code Of The Provider |
024525516 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
3933 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
199849.94 |
Total Medicare Allowed Amount |
109275.79 |
Total Medicare Payment Amount |
85669.98 |
Total Medicare Standardized Payment Amount |
79933.82 |
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 |
13 |
Number Of Medical Services |
3933 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
199849.94 |
Total Medical Medicare Allowed Amount |
109275.79 |
Total Medical Medicare Payment Amount |
85669.98 |
Total Medical Medicare Standardized Payment Amount |
79933.82 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
188 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
36 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
184 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8432 |