National Provider Identifier [NPI]: |
1649556416 |
Last Name Of The Provider |
IVANOVA |
First Name Of The Provider |
VALENTYNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
320 E NORTH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PITTSBURGH |
Zip Code Of The Provider |
152124756 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
545 |
Number Of Medicare Beneficiaries |
315 |
Total Submitted Charge Amount |
63515 |
Total Medicare Allowed Amount |
31862.61 |
Total Medicare Payment Amount |
23383.31 |
Total Medicare Standardized Payment Amount |
23893.16 |
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 |
24 |
Number Of Medical Services |
545 |
Number Of Medicare Beneficiaries With Medical Services |
315 |
Total Medical Submitted Charge Amount |
63515 |
Total Medical Medicare Allowed Amount |
31862.61 |
Total Medical Medicare Payment Amount |
23383.31 |
Total Medical Medicare Standardized Payment Amount |
23893.16 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
165 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
303 |
Number Of Black or African American Beneficiaries |
|
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 |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6443 |