National Provider Identifier [NPI]: |
1396034674 |
Last Name Of The Provider |
KAUFMAN |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 STATE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ERIE |
Zip Code Of The Provider |
165500002 |
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 |
56 |
Number Of Services |
275 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
244703 |
Total Medicare Allowed Amount |
27551.87 |
Total Medicare Payment Amount |
21291.56 |
Total Medicare Standardized Payment Amount |
21479.14 |
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 |
56 |
Number Of Medical Services |
275 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
244703 |
Total Medical Medicare Allowed Amount |
27551.87 |
Total Medical Medicare Payment Amount |
21291.56 |
Total Medical Medicare Standardized Payment Amount |
21479.14 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
162 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
251 |
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 |
203 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
70 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4117 |