National Provider Identifier [NPI]: |
1548245236 |
Last Name Of The Provider |
DYE |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MPT, MOTR/L, ATC, |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
36 WINN DRIVE |
Street Address 2 Of The Provider |
SUITE #100 |
City Of The Provider |
REXBURG |
Zip Code Of The Provider |
83440 |
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 |
22 |
Number Of Services |
8405 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
347867 |
Total Medicare Allowed Amount |
207668.31 |
Total Medicare Payment Amount |
158078.69 |
Total Medicare Standardized Payment Amount |
120187.03 |
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 |
22 |
Number Of Medical Services |
8405 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
347867 |
Total Medical Medicare Allowed Amount |
207668.31 |
Total Medical Medicare Payment Amount |
158078.69 |
Total Medical Medicare Standardized Payment Amount |
120187.03 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
85 |
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 |
162 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9185 |