National Provider Identifier [NPI]: |
1114925146 |
Last Name Of The Provider |
SCOTT |
First Name Of The Provider |
GERALD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
601 MAIN ST |
Street Address 2 Of The Provider |
STE 205 |
City Of The Provider |
DUNEDIN |
Zip Code Of The Provider |
346985848 |
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 |
5 |
Number Of Services |
691 |
Number Of Medicare Beneficiaries |
626 |
Total Submitted Charge Amount |
111109.61 |
Total Medicare Allowed Amount |
109135.9 |
Total Medicare Payment Amount |
84249.92 |
Total Medicare Standardized Payment Amount |
81749.48 |
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 |
5 |
Number Of Medical Services |
691 |
Number Of Medicare Beneficiaries With Medical Services |
626 |
Total Medical Submitted Charge Amount |
111109.61 |
Total Medical Medicare Allowed Amount |
109135.9 |
Total Medical Medicare Payment Amount |
84249.92 |
Total Medical Medicare Standardized Payment Amount |
81749.48 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
299 |
Number Of Beneficiaries Age 75 to 84 |
238 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
359 |
Number Of Male Beneficiaries |
267 |
Number Of Non Hispanic White Beneficiaries |
586 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
592 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0219 |