National Provider Identifier [NPI]: |
1770651259 |
Last Name Of The Provider |
OSIPOWICZ |
First Name Of The Provider |
TADEK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7718 BRADLEY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BETHESDA |
Zip Code Of The Provider |
208171443 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
18907 |
Number Of Medicare Beneficiaries |
404 |
Total Submitted Charge Amount |
665687.75 |
Total Medicare Allowed Amount |
543184.67 |
Total Medicare Payment Amount |
422075.74 |
Total Medicare Standardized Payment Amount |
285716.8 |
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 |
18907 |
Number Of Medicare Beneficiaries With Medical Services |
404 |
Total Medical Submitted Charge Amount |
665687.75 |
Total Medical Medicare Allowed Amount |
543184.67 |
Total Medical Medicare Payment Amount |
422075.74 |
Total Medical Medicare Standardized Payment Amount |
285716.8 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
218 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
303 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
197 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
167 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
13 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
391 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4313 |