National Provider Identifier [NPI]: |
1154624575 |
Last Name Of The Provider |
SONG |
First Name Of The Provider |
MONICA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.A. CCC-A |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2700 SILVERSIDE RD |
Street Address 2 Of The Provider |
SUITE 3A |
City Of The Provider |
WILMINGTON |
Zip Code Of The Provider |
198103719 |
State Code Of The Provider |
DE |
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 |
912 |
Number Of Medicare Beneficiaries |
382 |
Total Submitted Charge Amount |
83185 |
Total Medicare Allowed Amount |
25336.97 |
Total Medicare Payment Amount |
18933.39 |
Total Medicare Standardized Payment Amount |
18577.02 |
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 |
912 |
Number Of Medicare Beneficiaries With Medical Services |
382 |
Total Medical Submitted Charge Amount |
83185 |
Total Medical Medicare Allowed Amount |
25336.97 |
Total Medical Medicare Payment Amount |
18933.39 |
Total Medical Medicare Standardized Payment Amount |
18577.02 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
298 |
Number Of Black or African American Beneficiaries |
64 |
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 |
343 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0465 |