National Provider Identifier [NPI]: |
1295775781 |
Last Name Of The Provider |
RICHARD |
First Name Of The Provider |
LISA |
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 |
110 29TH AVE N STE 202 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372031448 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
211 |
Number Of Medicare Beneficiaries |
204 |
Total Submitted Charge Amount |
196505.35 |
Total Medicare Allowed Amount |
28446.52 |
Total Medicare Payment Amount |
22238.33 |
Total Medicare Standardized Payment Amount |
23534.85 |
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 |
55 |
Number Of Medical Services |
211 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
196505.35 |
Total Medical Medicare Allowed Amount |
28446.52 |
Total Medical Medicare Payment Amount |
22238.33 |
Total Medical Medicare Standardized Payment Amount |
23534.85 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
176 |
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 |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.7996 |