National Provider Identifier [NPI]: |
1770797524 |
Last Name Of The Provider |
BUTKUS |
First Name Of The Provider |
NICOLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
RPT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
465 WOLCOTT RD |
Street Address 2 Of The Provider |
ADVANCED PHYSICAL THERAPY |
City Of The Provider |
WOLCOTT |
Zip Code Of The Provider |
067162613 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
7210 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
303208 |
Total Medicare Allowed Amount |
205591.85 |
Total Medicare Payment Amount |
158175.07 |
Total Medicare Standardized Payment Amount |
128585.67 |
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 |
7210 |
Number Of Medicare Beneficiaries With Medical Services |
181 |
Total Medical Submitted Charge Amount |
303208 |
Total Medical Medicare Allowed Amount |
205591.85 |
Total Medical Medicare Payment Amount |
158175.07 |
Total Medical Medicare Standardized Payment Amount |
128585.67 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
167 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1853 |