National Provider Identifier [NPI]: |
1619129350 |
Last Name Of The Provider |
BEDYNERMAN |
First Name Of The Provider |
KRISTINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2780 CLEVELAND AVE |
Street Address 2 Of The Provider |
SUITE 805 |
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339015817 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
733 |
Number Of Medicare Beneficiaries |
293 |
Total Submitted Charge Amount |
198519 |
Total Medicare Allowed Amount |
74457.46 |
Total Medicare Payment Amount |
56890.1 |
Total Medicare Standardized Payment Amount |
54238.58 |
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 |
15 |
Number Of Medical Services |
733 |
Number Of Medicare Beneficiaries With Medical Services |
293 |
Total Medical Submitted Charge Amount |
198519 |
Total Medical Medicare Allowed Amount |
74457.46 |
Total Medical Medicare Payment Amount |
56890.1 |
Total Medical Medicare Standardized Payment Amount |
54238.58 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
129 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
259 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
162 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
40 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0351 |