National Provider Identifier [NPI]: |
1407020779 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.S. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1330 SOUTH FORT HARRISON |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEARWATER |
Zip Code Of The Provider |
33756 |
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 |
627 |
Number Of Medicare Beneficiaries |
292 |
Total Submitted Charge Amount |
44660 |
Total Medicare Allowed Amount |
18552.85 |
Total Medicare Payment Amount |
14181.93 |
Total Medicare Standardized Payment Amount |
14222.67 |
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 |
627 |
Number Of Medicare Beneficiaries With Medical Services |
292 |
Total Medical Submitted Charge Amount |
44660 |
Total Medical Medicare Allowed Amount |
18552.85 |
Total Medical Medicare Payment Amount |
14181.93 |
Total Medical Medicare Standardized Payment Amount |
14222.67 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
279 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
272 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.316 |