National Provider Identifier [NPI]: |
1609879600 |
Last Name Of The Provider |
SHELLY-LOHMAN |
First Name Of The Provider |
PATRICIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
AU.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1411 S 14TH STREET, SUITE F |
Street Address 2 Of The Provider |
AMELIA AUDIOLOGY |
City Of The Provider |
AMELIA ISLAND |
Zip Code Of The Provider |
320343092 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
385 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
20940 |
Total Medicare Allowed Amount |
10169.35 |
Total Medicare Payment Amount |
6974.83 |
Total Medicare Standardized Payment Amount |
7011.8 |
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 |
5 |
Number Of Medical Services |
385 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
20940 |
Total Medical Medicare Allowed Amount |
10169.35 |
Total Medical Medicare Payment Amount |
6974.83 |
Total Medical Medicare Standardized Payment Amount |
7011.8 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
92 |
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 |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.093 |