National Provider Identifier [NPI]: |
1134270325 |
Last Name Of The Provider |
BORTONE |
First Name Of The Provider |
ADELA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MA,CCC-A |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4320 WORNALL RD |
Street Address 2 Of The Provider |
512 |
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
641115941 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
412 |
Number Of Medicare Beneficiaries |
212 |
Total Submitted Charge Amount |
47630 |
Total Medicare Allowed Amount |
12203.47 |
Total Medicare Payment Amount |
9207.99 |
Total Medicare Standardized Payment Amount |
9385.7 |
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 |
4 |
Number Of Medical Services |
412 |
Number Of Medicare Beneficiaries With Medical Services |
212 |
Total Medical Submitted Charge Amount |
47630 |
Total Medical Medicare Allowed Amount |
12203.47 |
Total Medical Medicare Payment Amount |
9207.99 |
Total Medical Medicare Standardized Payment Amount |
9385.7 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
120 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
191 |
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.972 |