National Provider Identifier [NPI]: |
1720054315 |
Last Name Of The Provider |
TEEGARDEN |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12330 METCALF AVE |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
OVERLAND PARK |
Zip Code Of The Provider |
662131324 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
676 |
Number Of Medicare Beneficiaries |
166 |
Total Submitted Charge Amount |
69214 |
Total Medicare Allowed Amount |
32237.33 |
Total Medicare Payment Amount |
20530.77 |
Total Medicare Standardized Payment Amount |
22927.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
43 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
732 |
Total Drug Medicare AllowedAmount |
604.39 |
Total Drug Medicare PaymentAmount |
496.72 |
Total Drug Medicare Standardized Payment Amount |
496.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
633 |
Number Of Medicare Beneficiaries With Medical Services |
166 |
Total Medical Submitted Charge Amount |
68482 |
Total Medical Medicare Allowed Amount |
31632.94 |
Total Medical Medicare Payment Amount |
20034.05 |
Total Medical Medicare Standardized Payment Amount |
22431.25 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
149 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7951 |