| National Provider Identifier [NPI]: | 1700056363 |
| Last Name Of The Provider | BORER |
| First Name Of The Provider | SARAH |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | AU.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1875 DEMPSTER ST |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | PARK RIDGE |
| Zip Code Of The Provider | 600681186 |
| State Code Of The Provider | IL |
| 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 | 714 |
| Number Of Medicare Beneficiaries | 394 |
| Total Submitted Charge Amount | 75924 |
| Total Medicare Allowed Amount | 21321.61 |
| Total Medicare Payment Amount | 15971.24 |
| Total Medicare Standardized Payment Amount | 15061.86 |
| 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 | 714 |
| Number Of Medicare Beneficiaries With Medical Services | 394 |
| Total Medical Submitted Charge Amount | 75924 |
| Total Medical Medicare Allowed Amount | 21321.61 |
| Total Medical Medicare Payment Amount | 15971.24 |
| Total Medical Medicare Standardized Payment Amount | 15061.86 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 154 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 254 |
| Number Of Male Beneficiaries | 140 |
| Number Of Non Hispanic White Beneficiaries | 348 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 364 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0921 |