National Provider Identifier [NPI]: |
1700893419 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
JUDITH |
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 |
2727 W. MLK BLVD |
Street Address 2 Of The Provider |
TAMPA MEDICAL TOWERS, STE 300 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
33607 |
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 |
35 |
Number Of Services |
158 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
278214 |
Total Medicare Allowed Amount |
23509.23 |
Total Medicare Payment Amount |
18405.47 |
Total Medicare Standardized Payment Amount |
17888.8 |
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 |
35 |
Number Of Medical Services |
158 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
278214 |
Total Medical Medicare Allowed Amount |
23509.23 |
Total Medical Medicare Payment Amount |
18405.47 |
Total Medical Medicare Standardized Payment Amount |
17888.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
95 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0358 |