National Provider Identifier [NPI]: |
1598198137 |
Last Name Of The Provider |
COX |
First Name Of The Provider |
JENNIFER |
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 |
1555 BARRINGTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOFFMAN ESTATES |
Zip Code Of The Provider |
601691019 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
352 |
Number Of Medicare Beneficiaries |
341 |
Total Submitted Charge Amount |
243255 |
Total Medicare Allowed Amount |
36938.58 |
Total Medicare Payment Amount |
28872.67 |
Total Medicare Standardized Payment Amount |
26006.58 |
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 |
42 |
Number Of Medical Services |
352 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
243255 |
Total Medical Medicare Allowed Amount |
36938.58 |
Total Medical Medicare Payment Amount |
28872.67 |
Total Medical Medicare Standardized Payment Amount |
26006.58 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
191 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
302 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1952 |