National Provider Identifier [NPI]: |
1639286628 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
ANN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6TH AVENUE AND SPRUCE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST READOMG |
Zip Code Of The Provider |
196111428 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
311 |
Number Of Medicare Beneficiaries |
285 |
Total Submitted Charge Amount |
90084.6 |
Total Medicare Allowed Amount |
30416.59 |
Total Medicare Payment Amount |
23722.05 |
Total Medicare Standardized Payment Amount |
23973.08 |
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 |
50 |
Number Of Medical Services |
311 |
Number Of Medicare Beneficiaries With Medical Services |
285 |
Total Medical Submitted Charge Amount |
90084.6 |
Total Medical Medicare Allowed Amount |
30416.59 |
Total Medical Medicare Payment Amount |
23722.05 |
Total Medical Medicare Standardized Payment Amount |
23973.08 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
157 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
266 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5145 |