National Provider Identifier [NPI]: |
1932347895 |
Last Name Of The Provider |
PONDER |
First Name Of The Provider |
JONATHON |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 PINE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ABILENE |
Zip Code Of The Provider |
796012432 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
247 |
Number Of Medicare Beneficiaries |
240 |
Total Submitted Charge Amount |
212592 |
Total Medicare Allowed Amount |
27867.22 |
Total Medicare Payment Amount |
21697.99 |
Total Medicare Standardized Payment Amount |
22528.3 |
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 |
52 |
Number Of Medical Services |
247 |
Number Of Medicare Beneficiaries With Medical Services |
240 |
Total Medical Submitted Charge Amount |
212592 |
Total Medical Medicare Allowed Amount |
27867.22 |
Total Medical Medicare Payment Amount |
21697.99 |
Total Medical Medicare Standardized Payment Amount |
22528.3 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
203 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
178 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.437 |