National Provider Identifier [NPI]: |
1811121254 |
Last Name Of The Provider |
MYERS |
First Name Of The Provider |
DARCY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2202 HARLEM ROAD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
LOVES PARK |
Zip Code Of The Provider |
611112754 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
167 |
Number Of Medicare Beneficiaries |
154 |
Total Submitted Charge Amount |
511800 |
Total Medicare Allowed Amount |
55912.69 |
Total Medicare Payment Amount |
43118.54 |
Total Medicare Standardized Payment Amount |
42910.01 |
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 |
167 |
Number Of Medicare Beneficiaries With Medical Services |
154 |
Total Medical Submitted Charge Amount |
511800 |
Total Medical Medicare Allowed Amount |
55912.69 |
Total Medical Medicare Payment Amount |
43118.54 |
Total Medical Medicare Standardized Payment Amount |
42910.01 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
142 |
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 |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3574 |