National Provider Identifier [NPI]: |
1841521895 |
Last Name Of The Provider |
FRUTH |
First Name Of The Provider |
NICOLE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
AU.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6018 SANDY SPRINGS CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303283832 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
2 |
Number Of Services |
64 |
Number Of Medicare Beneficiaries |
14 |
Total Submitted Charge Amount |
11171.08 |
Total Medicare Allowed Amount |
1857.36 |
Total Medicare Payment Amount |
1456.14 |
Total Medicare Standardized Payment Amount |
1060.47 |
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 |
2 |
Number Of Medical Services |
64 |
Number Of Medicare Beneficiaries With Medical Services |
14 |
Total Medical Submitted Charge Amount |
11171.08 |
Total Medical Medicare Allowed Amount |
1857.36 |
Total Medical Medicare Payment Amount |
1456.14 |
Total Medical Medicare Standardized Payment Amount |
1060.47 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
0 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
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 |
|
Percent Of With Alzheimers Disease or Dementia |
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Percent Of With Asthma |
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Percent Of With Cancer |
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Percent Of With Heart Failure |
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Percent Of With Chronic Kidney Disease |
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Percent Of With Chronic Obstructive Pulmonary Disease |
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Percent Of With Depression |
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Percent Of With Diabetes |
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Percent Of With Hyperlipidemia |
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Percent Of With Hypertension |
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Percent Of With Ischemic Heart Disease |
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Percent Of With Osteoporosis |
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Percent Of With Rheumatoid Arthritis Osteoarthritis |
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Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9141 |