National Provider Identifier [NPI]: |
1063688679 |
Last Name Of The Provider |
ZDANYS |
First Name Of The Provider |
KRISTINA |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
263 FARMINGTON AVE |
Street Address 2 Of The Provider |
PSYCHIATRY |
City Of The Provider |
FARMINGTON |
Zip Code Of The Provider |
060306410 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
733 |
Number Of Medicare Beneficiaries |
243 |
Total Submitted Charge Amount |
123438 |
Total Medicare Allowed Amount |
61813.86 |
Total Medicare Payment Amount |
47018.53 |
Total Medicare Standardized Payment Amount |
44375.2 |
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 |
13 |
Number Of Medical Services |
733 |
Number Of Medicare Beneficiaries With Medical Services |
243 |
Total Medical Submitted Charge Amount |
123438 |
Total Medical Medicare Allowed Amount |
61813.86 |
Total Medical Medicare Payment Amount |
47018.53 |
Total Medical Medicare Standardized Payment Amount |
44375.2 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
211 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
63 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
28 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4486 |