National Provider Identifier [NPI]: |
1922382464 |
Last Name Of The Provider |
ALLEN |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
AU.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3009 N BALLAS RD |
Street Address 2 Of The Provider |
STE 380C |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631312322 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
624 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
59086 |
Total Medicare Allowed Amount |
22724.29 |
Total Medicare Payment Amount |
16234.72 |
Total Medicare Standardized Payment Amount |
16373.6 |
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 |
15 |
Number Of Medical Services |
624 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
59086 |
Total Medical Medicare Allowed Amount |
22724.29 |
Total Medical Medicare Payment Amount |
16234.72 |
Total Medical Medicare Standardized Payment Amount |
16373.6 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
298 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
304 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9984 |