| National Provider Identifier [NPI]: | 1992920821 |
| Last Name Of The Provider | NOVAK |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1501 N CAMPBELL AVE |
| Street Address 2 Of The Provider | DEPT OF PATHOLOGY, ROOM 1416, UNIVERSITY MEDICAL CENTER |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 85724 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 1361 |
| Number Of Medicare Beneficiaries | 547 |
| Total Submitted Charge Amount | 63804 |
| Total Medicare Allowed Amount | 28488.32 |
| Total Medicare Payment Amount | 21889.13 |
| Total Medicare Standardized Payment Amount | 22051.58 |
| 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 | 1361 |
| Number Of Medicare Beneficiaries With Medical Services | 547 |
| Total Medical Submitted Charge Amount | 63804 |
| Total Medical Medicare Allowed Amount | 28488.32 |
| Total Medical Medicare Payment Amount | 21889.13 |
| Total Medical Medicare Standardized Payment Amount | 22051.58 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 189 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 275 |
| Number Of Male Beneficiaries | 272 |
| Number Of Non Hispanic White Beneficiaries | 454 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 461 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.9867 |