National Provider Identifier [NPI]: |
1801089263 |
Last Name Of The Provider |
HANLEY |
First Name Of The Provider |
CORY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
PT |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
924 W CUSTER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PONTIAC |
Zip Code Of The Provider |
617641067 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
7284 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
473666 |
Total Medicare Allowed Amount |
183180.64 |
Total Medicare Payment Amount |
141001.57 |
Total Medicare Standardized Payment Amount |
87987.59 |
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 |
10 |
Number Of Medical Services |
7284 |
Number Of Medicare Beneficiaries With Medical Services |
168 |
Total Medical Submitted Charge Amount |
473666 |
Total Medical Medicare Allowed Amount |
183180.64 |
Total Medical Medicare Payment Amount |
141001.57 |
Total Medical Medicare Standardized Payment Amount |
87987.59 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
67 |
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 |
140 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.1423 |