National Provider Identifier [NPI]: |
1396846937 |
Last Name Of The Provider |
JULIAN |
First Name Of The Provider |
JANE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PT |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
134 PROFESSIONAL PARK DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCK HILL |
Zip Code Of The Provider |
297321178 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
3776 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
245020 |
Total Medicare Allowed Amount |
98459.33 |
Total Medicare Payment Amount |
75535.4 |
Total Medicare Standardized Payment Amount |
53372.2 |
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 |
14 |
Number Of Medical Services |
3776 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
245020 |
Total Medical Medicare Allowed Amount |
98459.33 |
Total Medical Medicare Payment Amount |
75535.4 |
Total Medical Medicare Standardized Payment Amount |
53372.2 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
182 |
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 |
192 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.91 |