National Provider Identifier [NPI]: |
1316942782 |
Last Name Of The Provider |
YAKUBOV |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3705 OLENTANGY RIVER RD |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432143467 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
2464 |
Number Of Medicare Beneficiaries |
1220 |
Total Submitted Charge Amount |
803254 |
Total Medicare Allowed Amount |
277810.25 |
Total Medicare Payment Amount |
210043.59 |
Total Medicare Standardized Payment Amount |
216741.17 |
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 |
56 |
Number Of Medical Services |
2464 |
Number Of Medicare Beneficiaries With Medical Services |
1220 |
Total Medical Submitted Charge Amount |
803254 |
Total Medical Medicare Allowed Amount |
277810.25 |
Total Medical Medicare Payment Amount |
210043.59 |
Total Medical Medicare Standardized Payment Amount |
216741.17 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
180 |
Number Of Beneficiaries Age 65 to 74 |
408 |
Number Of Beneficiaries Age 75 to 84 |
414 |
Number Of Beneficiaries Age Greater 84 |
218 |
Number Of Female Beneficiaries |
562 |
Number Of Male Beneficiaries |
658 |
Number Of Non Hispanic White Beneficiaries |
1097 |
Number Of Black or African American Beneficiaries |
82 |
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 |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
991 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
229 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8244 |