National Provider Identifier [NPI]: |
1871676262 |
Last Name Of The Provider |
KUSHCH |
First Name Of The Provider |
ALEXANDER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PH.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5821 HOLLYWOOD BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOLLYWOOD |
Zip Code Of The Provider |
330216308 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
845 |
Number Of Medicare Beneficiaries |
156 |
Total Submitted Charge Amount |
147475.66 |
Total Medicare Allowed Amount |
94384.06 |
Total Medicare Payment Amount |
73068.48 |
Total Medicare Standardized Payment Amount |
69405.25 |
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 |
7 |
Number Of Medical Services |
845 |
Number Of Medicare Beneficiaries With Medical Services |
156 |
Total Medical Submitted Charge Amount |
147475.66 |
Total Medical Medicare Allowed Amount |
94384.06 |
Total Medical Medicare Payment Amount |
73068.48 |
Total Medical Medicare Standardized Payment Amount |
69405.25 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
137 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
130 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
1.984 |