National Provider Identifier [NPI]: |
1689872806 |
Last Name Of The Provider |
MASON |
First Name Of The Provider |
AMBER |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4949 TAMIAMI TRL N |
Street Address 2 Of The Provider |
SUITE 206 |
City Of The Provider |
NAPLES |
Zip Code Of The Provider |
341033027 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
427 |
Number Of Medicare Beneficiaries |
419 |
Total Submitted Charge Amount |
913367.6 |
Total Medicare Allowed Amount |
159410.07 |
Total Medicare Payment Amount |
123436.75 |
Total Medicare Standardized Payment Amount |
115379.09 |
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 |
60 |
Number Of Medical Services |
427 |
Number Of Medicare Beneficiaries With Medical Services |
419 |
Total Medical Submitted Charge Amount |
913367.6 |
Total Medical Medicare Allowed Amount |
159410.07 |
Total Medical Medicare Payment Amount |
123436.75 |
Total Medical Medicare Standardized Payment Amount |
115379.09 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
198 |
Number Of Non Hispanic White Beneficiaries |
392 |
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 |
398 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1191 |