National Provider Identifier [NPI]: |
1134276256 |
Last Name Of The Provider |
PENTZ |
First Name Of The Provider |
DEBRA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1919 E MCKELLIPS RD |
Street Address 2 Of The Provider |
SUITE 106 |
City Of The Provider |
MESA |
Zip Code Of The Provider |
852032844 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Chiropractic |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
2 |
Number Of Services |
884 |
Number Of Medicare Beneficiaries |
144 |
Total Submitted Charge Amount |
53040 |
Total Medicare Allowed Amount |
34274.91 |
Total Medicare Payment Amount |
23014.96 |
Total Medicare Standardized Payment Amount |
23479.96 |
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 |
2 |
Number Of Medical Services |
884 |
Number Of Medicare Beneficiaries With Medical Services |
144 |
Total Medical Submitted Charge Amount |
53040 |
Total Medical Medicare Allowed Amount |
34274.91 |
Total Medical Medicare Payment Amount |
23014.96 |
Total Medical Medicare Standardized Payment Amount |
23479.96 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
40 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.7618 |