National Provider Identifier [NPI]: |
1588927172 |
Last Name Of The Provider |
AL-HASSAN |
First Name Of The Provider |
RABIATU |
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 |
4646 N MARINE DR |
Street Address 2 Of The Provider |
DEPARTMENT OF ANESTHESIA |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606405759 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
316 |
Number Of Medicare Beneficiaries |
306 |
Total Submitted Charge Amount |
314618.09 |
Total Medicare Allowed Amount |
39901.81 |
Total Medicare Payment Amount |
31068.21 |
Total Medicare Standardized Payment Amount |
27932.83 |
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 |
53 |
Number Of Medical Services |
316 |
Number Of Medicare Beneficiaries With Medical Services |
306 |
Total Medical Submitted Charge Amount |
314618.09 |
Total Medical Medicare Allowed Amount |
39901.81 |
Total Medical Medicare Payment Amount |
31068.21 |
Total Medical Medicare Standardized Payment Amount |
27932.83 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
148 |
Number Of Black or African American Beneficiaries |
127 |
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 |
183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.0767 |