National Provider Identifier [NPI]: |
1902906860 |
Last Name Of The Provider |
KITKO |
First Name Of The Provider |
TERESA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
774 CHRISTIANA ROAD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
19713 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
491 |
Number Of Medicare Beneficiaries |
127 |
Total Submitted Charge Amount |
1220900.63 |
Total Medicare Allowed Amount |
53212.01 |
Total Medicare Payment Amount |
41668.91 |
Total Medicare Standardized Payment Amount |
45826.64 |
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 |
55 |
Number Of Medical Services |
491 |
Number Of Medicare Beneficiaries With Medical Services |
127 |
Total Medical Submitted Charge Amount |
1220900.63 |
Total Medical Medicare Allowed Amount |
53212.01 |
Total Medical Medicare Payment Amount |
41668.91 |
Total Medical Medicare Standardized Payment Amount |
45826.64 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
109 |
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 |
109 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.2563 |