National Provider Identifier [NPI]: |
1144295379 |
Last Name Of The Provider |
SHERIDAN |
First Name Of The Provider |
DEIDRA |
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 |
8333 N DAVIS HWY |
Street Address 2 Of The Provider |
WEST FLORIDA MEDICAL CENTER CLINIC PA |
City Of The Provider |
PENSACOLA |
Zip Code Of The Provider |
32514 |
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 |
30 |
Number Of Services |
100 |
Number Of Medicare Beneficiaries |
98 |
Total Submitted Charge Amount |
110988.9 |
Total Medicare Allowed Amount |
12362.4 |
Total Medicare Payment Amount |
9490.35 |
Total Medicare Standardized Payment Amount |
10268.38 |
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 |
30 |
Number Of Medical Services |
100 |
Number Of Medicare Beneficiaries With Medical Services |
98 |
Total Medical Submitted Charge Amount |
110988.9 |
Total Medical Medicare Allowed Amount |
12362.4 |
Total Medical Medicare Payment Amount |
9490.35 |
Total Medical Medicare Standardized Payment Amount |
10268.38 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
87 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2868 |