National Provider Identifier [NPI]: |
1871855858 |
Last Name Of The Provider |
D'AMATO |
First Name Of The Provider |
CHRISTINE |
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 |
901 MACARTHUR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463212901 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
284 |
Number Of Medicare Beneficiaries |
275 |
Total Submitted Charge Amount |
481676 |
Total Medicare Allowed Amount |
39402.81 |
Total Medicare Payment Amount |
30871.52 |
Total Medicare Standardized Payment Amount |
27766.48 |
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 |
58 |
Number Of Medical Services |
284 |
Number Of Medicare Beneficiaries With Medical Services |
275 |
Total Medical Submitted Charge Amount |
481676 |
Total Medical Medicare Allowed Amount |
39402.81 |
Total Medical Medicare Payment Amount |
30871.52 |
Total Medical Medicare Standardized Payment Amount |
27766.48 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
158 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
244 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
247 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6848 |