National Provider Identifier [NPI]: |
1124342795 |
Last Name Of The Provider |
KEMPLE |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 LAKELAND HILLS BLVD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKELAND |
Zip Code Of The Provider |
338053019 |
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 |
49 |
Number Of Services |
326 |
Number Of Medicare Beneficiaries |
320 |
Total Submitted Charge Amount |
374643 |
Total Medicare Allowed Amount |
81349.76 |
Total Medicare Payment Amount |
63441.99 |
Total Medicare Standardized Payment Amount |
61554.51 |
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 |
49 |
Number Of Medical Services |
326 |
Number Of Medicare Beneficiaries With Medical Services |
320 |
Total Medical Submitted Charge Amount |
374643 |
Total Medical Medicare Allowed Amount |
81349.76 |
Total Medical Medicare Payment Amount |
63441.99 |
Total Medical Medicare Standardized Payment Amount |
61554.51 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
147 |
Number Of Non Hispanic White Beneficiaries |
292 |
Number Of Black or African American Beneficiaries |
16 |
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 |
274 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3628 |