National Provider Identifier [NPI]: |
1992787097 |
Last Name Of The Provider |
KUSCH |
First Name Of The Provider |
SHANON |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MS CCCA FAAA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1272 GARRISON DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MURFREESBORO |
Zip Code Of The Provider |
371292570 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Audiologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
422 |
Number Of Medicare Beneficiaries |
278 |
Total Submitted Charge Amount |
33364 |
Total Medicare Allowed Amount |
12474.21 |
Total Medicare Payment Amount |
8611.74 |
Total Medicare Standardized Payment Amount |
9004.7 |
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 |
6 |
Number Of Medical Services |
422 |
Number Of Medicare Beneficiaries With Medical Services |
278 |
Total Medical Submitted Charge Amount |
33364 |
Total Medical Medicare Allowed Amount |
12474.21 |
Total Medical Medicare Payment Amount |
8611.74 |
Total Medical Medicare Standardized Payment Amount |
9004.7 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
253 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.134 |