National Provider Identifier [NPI]: |
1750366845 |
Last Name Of The Provider |
DUFFIELD |
First Name Of The Provider |
CHRISTI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4060 4TH AVE |
Street Address 2 Of The Provider |
#105 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921032116 |
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 |
12 |
Number Of Services |
1954 |
Number Of Medicare Beneficiaries |
94 |
Total Submitted Charge Amount |
85273.01 |
Total Medicare Allowed Amount |
50383.56 |
Total Medicare Payment Amount |
38213.84 |
Total Medicare Standardized Payment Amount |
31380.1 |
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 |
12 |
Number Of Medical Services |
1954 |
Number Of Medicare Beneficiaries With Medical Services |
94 |
Total Medical Submitted Charge Amount |
85273.01 |
Total Medical Medicare Allowed Amount |
50383.56 |
Total Medical Medicare Payment Amount |
38213.84 |
Total Medical Medicare Standardized Payment Amount |
31380.1 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
66 |
Number Of Male Beneficiaries |
28 |
Number Of Non Hispanic White Beneficiaries |
72 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
26 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0288 |