National Provider Identifier [NPI]: |
1134268758 |
Last Name Of The Provider |
CLIFTON |
First Name Of The Provider |
ANN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
AU.D., CCC-A |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
775 WAUKEGAN RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
DEERFIELD |
Zip Code Of The Provider |
600154342 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
3066 |
Number Of Medicare Beneficiaries |
1598 |
Total Submitted Charge Amount |
101412 |
Total Medicare Allowed Amount |
70066.37 |
Total Medicare Payment Amount |
50085.21 |
Total Medicare Standardized Payment Amount |
56407.43 |
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 |
5 |
Number Of Medical Services |
3066 |
Number Of Medicare Beneficiaries With Medical Services |
1598 |
Total Medical Submitted Charge Amount |
101412 |
Total Medical Medicare Allowed Amount |
70066.37 |
Total Medical Medicare Payment Amount |
50085.21 |
Total Medical Medicare Standardized Payment Amount |
56407.43 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
204 |
Number Of Beneficiaries Age 65 to 74 |
282 |
Number Of Beneficiaries Age 75 to 84 |
461 |
Number Of Beneficiaries Age Greater 84 |
651 |
Number Of Female Beneficiaries |
1113 |
Number Of Male Beneficiaries |
485 |
Number Of Non Hispanic White Beneficiaries |
1384 |
Number Of Black or African American Beneficiaries |
194 |
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 |
193 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1405 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
29 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.2236 |