National Provider Identifier [NPI]: |
1396984217 |
Last Name Of The Provider |
FRIMAN |
First Name Of The Provider |
KRISTINA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
LCSW |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1405 CROCKER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770194320 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Licensed Clinical Social Worker |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
599 |
Number Of Medicare Beneficiaries |
71 |
Total Submitted Charge Amount |
69981.12 |
Total Medicare Allowed Amount |
38074.34 |
Total Medicare Payment Amount |
29853.07 |
Total Medicare Standardized Payment Amount |
30198.19 |
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 |
3 |
Number Of Medical Services |
599 |
Number Of Medicare Beneficiaries With Medical Services |
71 |
Total Medical Submitted Charge Amount |
69981.12 |
Total Medical Medicare Allowed Amount |
38074.34 |
Total Medical Medicare Payment Amount |
29853.07 |
Total Medical Medicare Standardized Payment Amount |
30198.19 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
42 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
43 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
42 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.6888 |