National Provider Identifier [NPI]: |
1861480725 |
Last Name Of The Provider |
THYNE |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
P.T. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4010 6TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
KEARNEY |
Zip Code Of The Provider |
688453393 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
1526 |
Number Of Medicare Beneficiaries |
100 |
Total Submitted Charge Amount |
66196 |
Total Medicare Allowed Amount |
43306.03 |
Total Medicare Payment Amount |
31518.81 |
Total Medicare Standardized Payment Amount |
24357.73 |
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 |
9 |
Number Of Medical Services |
1526 |
Number Of Medicare Beneficiaries With Medical Services |
100 |
Total Medical Submitted Charge Amount |
66196 |
Total Medical Medicare Allowed Amount |
43306.03 |
Total Medical Medicare Payment Amount |
31518.81 |
Total Medical Medicare Standardized Payment Amount |
24357.73 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
56 |
Number Of Male Beneficiaries |
44 |
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 |
86 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.9192 |