National Provider Identifier [NPI]: |
1164612693 |
Last Name Of The Provider |
WICKER |
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 |
150 N EAGLE CREEK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEXINGTON |
Zip Code Of The Provider |
405091805 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
306 |
Number Of Medicare Beneficiaries |
300 |
Total Submitted Charge Amount |
221288.35 |
Total Medicare Allowed Amount |
57605.88 |
Total Medicare Payment Amount |
44977.6 |
Total Medicare Standardized Payment Amount |
46928.79 |
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 |
45 |
Number Of Medical Services |
306 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
221288.35 |
Total Medical Medicare Allowed Amount |
57605.88 |
Total Medical Medicare Payment Amount |
44977.6 |
Total Medical Medicare Standardized Payment Amount |
46928.79 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
279 |
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 |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2222 |