National Provider Identifier [NPI]: |
1013026814 |
Last Name Of The Provider |
BENSON |
First Name Of The Provider |
RACHEL |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
PT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8807 W 400 N |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
MICHIGAN CITY |
Zip Code Of The Provider |
463609330 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2573 |
Number Of Medicare Beneficiaries |
57 |
Total Submitted Charge Amount |
111115 |
Total Medicare Allowed Amount |
64926.14 |
Total Medicare Payment Amount |
50631.17 |
Total Medicare Standardized Payment Amount |
37057.03 |
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 |
18 |
Number Of Medical Services |
2573 |
Number Of Medicare Beneficiaries With Medical Services |
57 |
Total Medical Submitted Charge Amount |
111115 |
Total Medical Medicare Allowed Amount |
64926.14 |
Total Medical Medicare Payment Amount |
50631.17 |
Total Medical Medicare Standardized Payment Amount |
37057.03 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
14 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
32 |
Number Of Male Beneficiaries |
25 |
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 |
57 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7693 |