National Provider Identifier [NPI]: |
1528058997 |
Last Name Of The Provider |
NIKIFOROV |
First Name Of The Provider |
SERGEI |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4999 LOUISE DR |
Street Address 2 Of The Provider |
STE 105 |
City Of The Provider |
MECHANICSBURG |
Zip Code Of The Provider |
170556907 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
291 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
327200 |
Total Medicare Allowed Amount |
42978.1 |
Total Medicare Payment Amount |
33328.32 |
Total Medicare Standardized Payment Amount |
33992.29 |
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 |
71 |
Number Of Medical Services |
291 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
327200 |
Total Medical Medicare Allowed Amount |
42978.1 |
Total Medical Medicare Payment Amount |
33328.32 |
Total Medical Medicare Standardized Payment Amount |
33992.29 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
228 |
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 |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5559 |