National Provider Identifier [NPI]: |
1619248747 |
Last Name Of The Provider |
KLEEB |
First Name Of The Provider |
LANDON |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5325 FARAON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT JOSEPH |
Zip Code Of The Provider |
645063488 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
278 |
Number Of Medicare Beneficiaries |
262 |
Total Submitted Charge Amount |
207970 |
Total Medicare Allowed Amount |
31501.41 |
Total Medicare Payment Amount |
24651.06 |
Total Medicare Standardized Payment Amount |
25261.07 |
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 |
54 |
Number Of Medical Services |
278 |
Number Of Medicare Beneficiaries With Medical Services |
262 |
Total Medical Submitted Charge Amount |
207970 |
Total Medical Medicare Allowed Amount |
31501.41 |
Total Medical Medicare Payment Amount |
24651.06 |
Total Medical Medicare Standardized Payment Amount |
25261.07 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
243 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
202 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.853 |