National Provider Identifier [NPI]: |
1407909203 |
Last Name Of The Provider |
NEMANOV |
First Name Of The Provider |
LYUBOV |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
AU.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3550 LUTHERAN PKWY W STE 102B |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHEAT RIDGE |
Zip Code Of The Provider |
800336013 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
189 |
Number Of Medicare Beneficiaries |
140 |
Total Submitted Charge Amount |
6626.86 |
Total Medicare Allowed Amount |
6266.36 |
Total Medicare Payment Amount |
4548.71 |
Total Medicare Standardized Payment Amount |
4922.01 |
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 |
8 |
Number Of Medical Services |
189 |
Number Of Medicare Beneficiaries With Medical Services |
140 |
Total Medical Submitted Charge Amount |
6626.86 |
Total Medical Medicare Allowed Amount |
6266.36 |
Total Medical Medicare Payment Amount |
4548.71 |
Total Medical Medicare Standardized Payment Amount |
4922.01 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
115 |
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 |
125 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1556 |