National Provider Identifier [NPI]: |
1891815445 |
Last Name Of The Provider |
NYAMBIO |
First Name Of The Provider |
JEAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4707 SAINT ANTOINE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482011427 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
270 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
212195 |
Total Medicare Allowed Amount |
33531.48 |
Total Medicare Payment Amount |
25304.06 |
Total Medicare Standardized Payment Amount |
24049.97 |
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 |
46 |
Number Of Medical Services |
270 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
212195 |
Total Medical Medicare Allowed Amount |
33531.48 |
Total Medical Medicare Payment Amount |
25304.06 |
Total Medical Medicare Standardized Payment Amount |
24049.97 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
176 |
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 |
149 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.7225 |