National Provider Identifier [NPI]: |
1306175153 |
Last Name Of The Provider |
EATON |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 GENESYS PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND BLANC |
Zip Code Of The Provider |
484398065 |
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 |
48 |
Number Of Services |
169 |
Number Of Medicare Beneficiaries |
167 |
Total Submitted Charge Amount |
132624 |
Total Medicare Allowed Amount |
23087.98 |
Total Medicare Payment Amount |
17984.12 |
Total Medicare Standardized Payment Amount |
18281.94 |
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 |
48 |
Number Of Medical Services |
169 |
Number Of Medicare Beneficiaries With Medical Services |
167 |
Total Medical Submitted Charge Amount |
132624 |
Total Medical Medicare Allowed Amount |
23087.98 |
Total Medical Medicare Payment Amount |
17984.12 |
Total Medical Medicare Standardized Payment Amount |
18281.94 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
148 |
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 |
135 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5639 |