National Provider Identifier [NPI]: |
1508830969 |
Last Name Of The Provider |
FINKENBINE |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
221 NE GLEN OAK AVE |
Street Address 2 Of The Provider |
7 WEST |
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
616360001 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
354 |
Number Of Medicare Beneficiaries |
135 |
Total Submitted Charge Amount |
59957 |
Total Medicare Allowed Amount |
27663.86 |
Total Medicare Payment Amount |
21425.28 |
Total Medicare Standardized Payment Amount |
21765.75 |
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 |
12 |
Number Of Medical Services |
354 |
Number Of Medicare Beneficiaries With Medical Services |
135 |
Total Medical Submitted Charge Amount |
59957 |
Total Medical Medicare Allowed Amount |
27663.86 |
Total Medical Medicare Payment Amount |
21425.28 |
Total Medical Medicare Standardized Payment Amount |
21765.75 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
86 |
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 |
80 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
121 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
56 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
55 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6178 |