National Provider Identifier [NPI]: |
1508803164 |
Last Name Of The Provider |
REXROTH |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
PSYD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
355 W 16TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462022207 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
941 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
278529.5 |
Total Medicare Allowed Amount |
75360.2 |
Total Medicare Payment Amount |
56990.66 |
Total Medicare Standardized Payment Amount |
34893.37 |
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 |
4 |
Number Of Medical Services |
941 |
Number Of Medicare Beneficiaries With Medical Services |
268 |
Total Medical Submitted Charge Amount |
278529.5 |
Total Medical Medicare Allowed Amount |
75360.2 |
Total Medical Medicare Payment Amount |
56990.66 |
Total Medical Medicare Standardized Payment Amount |
34893.37 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
167 |
Number Of Black or African American Beneficiaries |
89 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
147 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
47 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4873 |