Medicare Facts for Mary L. Calderone


National Provider Identifier [NPI]: 1124274071
Last Name Of The Provider CALDERONE
First Name Of The Provider MARY
Middle Initial Of The Provider L
Credentials Of The Provider M.A.C.C.C.A.
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 360 E LOSEY ST
Street Address 2 Of The Provider
City Of The Provider GALESBURG
Zip Code Of The Provider 614012843
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 4
Number Of Services 220
Number Of Medicare Beneficiaries 172
Total Submitted Charge Amount 21008
Total Medicare Allowed Amount 7536.34
Total Medicare Payment Amount 4719.92
Total Medicare Standardized Payment Amount 5145.06
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 4
Number Of Medical Services 220
Number Of Medicare Beneficiaries With Medical Services 172
Total Medical Submitted Charge Amount 21008
Total Medical Medicare Allowed Amount 7536.34
Total Medical Medicare Payment Amount 4719.92
Total Medical Medicare Standardized Payment Amount 5145.06
Average Age Of Beneficiaries 78
Number Of Beneficiaries Age Less65 11
Number Of Beneficiaries Age 65 to 74 61
Number Of Beneficiaries Age 75 to 84 47
Number Of Beneficiaries Age Greater 84 53
Number Of Female Beneficiaries 96
Number Of Male Beneficiaries 76
Number Of Non Hispanic White Beneficiaries
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
Number Of Beneficiaries With Medicare Medicaid Entitlement
Percent Of With Atrial Fibrillation 11
Percent Of With Alzheimers Disease or Dementia 10
Percent Of With Asthma 10
Percent Of With Cancer 12
Percent Of With Heart Failure 19
Percent Of With Chronic Kidney Disease 24
Percent Of With Chronic Obstructive Pulmonary Disease 16
Percent Of With Depression 13
Percent Of With Diabetes 27
Percent Of With Hyperlipidemia 52
Percent Of With Hypertension 63
Percent Of With Ischemic Heart Disease 35
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 41
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke 8
Average HCC Risk Score Of Beneficiaries 1.2303

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