National Provider Identifier [NPI]: |
1528315843 |
Last Name Of The Provider |
KUNKLER |
First Name Of The Provider |
CHRISTEN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
DPT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
909 DAVIS ST |
Street Address 2 Of The Provider |
SUTE 220 |
City Of The Provider |
EVANSTON |
Zip Code Of The Provider |
602013683 |
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 |
5 |
Number Of Services |
1080 |
Number Of Medicare Beneficiaries |
55 |
Total Submitted Charge Amount |
90118 |
Total Medicare Allowed Amount |
31052.44 |
Total Medicare Payment Amount |
23442.42 |
Total Medicare Standardized Payment Amount |
17001.99 |
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 |
5 |
Number Of Medical Services |
1080 |
Number Of Medicare Beneficiaries With Medical Services |
55 |
Total Medical Submitted Charge Amount |
90118 |
Total Medical Medicare Allowed Amount |
31052.44 |
Total Medical Medicare Payment Amount |
23442.42 |
Total Medical Medicare Standardized Payment Amount |
17001.99 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
28 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
19 |
Number Of Non Hispanic White Beneficiaries |
44 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
29 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
38 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8002 |