National Provider Identifier [NPI]: |
1528304011 |
Last Name Of The Provider |
HAMMOND |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2927 KESWICK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212112733 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
217 |
Number Of Medicare Beneficiaries |
209 |
Total Submitted Charge Amount |
185484 |
Total Medicare Allowed Amount |
50613.88 |
Total Medicare Payment Amount |
39632.06 |
Total Medicare Standardized Payment Amount |
40858.53 |
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 |
60 |
Number Of Medical Services |
217 |
Number Of Medicare Beneficiaries With Medical Services |
209 |
Total Medical Submitted Charge Amount |
185484 |
Total Medical Medicare Allowed Amount |
50613.88 |
Total Medical Medicare Payment Amount |
39632.06 |
Total Medical Medicare Standardized Payment Amount |
40858.53 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
171 |
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 |
152 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6903 |