National Provider Identifier [NPI]: |
1699067553 |
Last Name Of The Provider |
DUNCAN |
First Name Of The Provider |
NICOLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
AUD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
992 UNION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BANGOR |
Zip Code Of The Provider |
044013057 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
388 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
18468 |
Total Medicare Allowed Amount |
10277.2 |
Total Medicare Payment Amount |
6950.12 |
Total Medicare Standardized Payment Amount |
7391.2 |
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 |
9 |
Number Of Medical Services |
388 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
18468 |
Total Medical Medicare Allowed Amount |
10277.2 |
Total Medical Medicare Payment Amount |
6950.12 |
Total Medical Medicare Standardized Payment Amount |
7391.2 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
70 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.009 |