National Provider Identifier [NPI]: |
1861628711 |
Last Name Of The Provider |
NOVACEK |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 S COLUMBIA RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND FORKS |
Zip Code Of The Provider |
582014032 |
State Code Of The Provider |
ND |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1646 |
Number Of Medicare Beneficiaries |
380 |
Total Submitted Charge Amount |
145601.5 |
Total Medicare Allowed Amount |
69532.53 |
Total Medicare Payment Amount |
50559.76 |
Total Medicare Standardized Payment Amount |
51335.1 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
349 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
14 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
254 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
1.4286 |