National Provider Identifier [NPI]: |
1154404754 |
Last Name Of The Provider |
KRUPNIKOVA |
First Name Of The Provider |
NADIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 CHURCH ST |
Street Address 2 Of The Provider |
SUITE 602 |
City Of The Provider |
ROCKVILLE |
Zip Code Of The Provider |
20850 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
808 |
Number Of Medicare Beneficiaries |
48 |
Total Submitted Charge Amount |
75231.83 |
Total Medicare Allowed Amount |
67827.07 |
Total Medicare Payment Amount |
52947.83 |
Total Medicare Standardized Payment Amount |
50058.14 |
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 |
3 |
Number Of Medical Services |
808 |
Number Of Medicare Beneficiaries With Medical Services |
48 |
Total Medical Submitted Charge Amount |
75231.83 |
Total Medical Medicare Allowed Amount |
67827.07 |
Total Medical Medicare Payment Amount |
52947.83 |
Total Medical Medicare Standardized Payment Amount |
50058.14 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
12 |
Number Of Beneficiaries Age 75 to 84 |
16 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
31 |
Number Of Male Beneficiaries |
17 |
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 |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
75 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.1651 |