National Provider Identifier [NPI]: |
1659619336 |
Last Name Of The Provider |
MABLE |
First Name Of The Provider |
RANI |
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 |
3800 RESERVOIR RD NW |
Street Address 2 Of The Provider |
CCC BLDG, LOWER LEVEL, DEPARTMENT OF ANESTHESIA |
City Of The Provider |
WASHINGTON |
Zip Code Of The Provider |
200072113 |
State Code Of The Provider |
DC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
196 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
116975.67 |
Total Medicare Allowed Amount |
30801.55 |
Total Medicare Payment Amount |
23246.63 |
Total Medicare Standardized Payment Amount |
21672.02 |
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 |
47 |
Number Of Medical Services |
196 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
116975.67 |
Total Medical Medicare Allowed Amount |
30801.55 |
Total Medical Medicare Payment Amount |
23246.63 |
Total Medical Medicare Standardized Payment Amount |
21672.02 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
105 |
Number Of Black or African American Beneficiaries |
63 |
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 |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.047 |