National Provider Identifier [NPI]: |
1497086854 |
Last Name Of The Provider |
SWEEZY |
First Name Of The Provider |
KIMBERLY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
245 ALVORD PARK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TORRINGTON |
Zip Code Of The Provider |
067903493 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
107 |
Number Of Services |
1008 |
Number Of Medicare Beneficiaries |
279 |
Total Submitted Charge Amount |
661518 |
Total Medicare Allowed Amount |
52383.41 |
Total Medicare Payment Amount |
40469.16 |
Total Medicare Standardized Payment Amount |
42641.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
146 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
2824 |
Total Drug Medicare AllowedAmount |
1671.97 |
Total Drug Medicare PaymentAmount |
1310.77 |
Total Drug Medicare Standardized Payment Amount |
1310.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
102 |
Number Of Medical Services |
862 |
Number Of Medicare Beneficiaries With Medical Services |
279 |
Total Medical Submitted Charge Amount |
658694 |
Total Medical Medicare Allowed Amount |
50711.44 |
Total Medical Medicare Payment Amount |
39158.39 |
Total Medical Medicare Standardized Payment Amount |
41330.61 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
258 |
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 |
148 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4216 |