National Provider Identifier [NPI]: |
1275626939 |
Last Name Of The Provider |
LIVINGSTONE |
First Name Of The Provider |
IAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
450 S WILLARD ST |
Street Address 2 Of The Provider |
SUITE 107 |
City Of The Provider |
COTTONWOOD |
Zip Code Of The Provider |
863266743 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
668 |
Number Of Medicare Beneficiaries |
345 |
Total Submitted Charge Amount |
181902 |
Total Medicare Allowed Amount |
68378.16 |
Total Medicare Payment Amount |
52191.15 |
Total Medicare Standardized Payment Amount |
51919.3 |
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 |
32 |
Number Of Medical Services |
668 |
Number Of Medicare Beneficiaries With Medical Services |
345 |
Total Medical Submitted Charge Amount |
181902 |
Total Medical Medicare Allowed Amount |
68378.16 |
Total Medical Medicare Payment Amount |
52191.15 |
Total Medical Medicare Standardized Payment Amount |
51919.3 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
315 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
289 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
37 |
Average HCC Risk Score Of Beneficiaries |
1.3799 |