National Provider Identifier [NPI]: |
1982690616 |
Last Name Of The Provider |
SENS |
First Name Of The Provider |
JEAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
RN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2139 AUBURN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452192906 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
165 |
Number Of Medicare Beneficiaries |
162 |
Total Submitted Charge Amount |
205014 |
Total Medicare Allowed Amount |
23759.71 |
Total Medicare Payment Amount |
18460.41 |
Total Medicare Standardized Payment Amount |
18641.7 |
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 |
37 |
Number Of Medical Services |
165 |
Number Of Medicare Beneficiaries With Medical Services |
162 |
Total Medical Submitted Charge Amount |
205014 |
Total Medical Medicare Allowed Amount |
23759.71 |
Total Medical Medicare Payment Amount |
18460.41 |
Total Medical Medicare Standardized Payment Amount |
18641.7 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
127 |
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 |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.8626 |