National Provider Identifier [NPI]: |
1972736965 |
Last Name Of The Provider |
KISER |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2341 MCCALLIE AVE |
Street Address 2 Of The Provider |
SUITE 402 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374043239 |
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 |
40 |
Number Of Services |
204 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
260718 |
Total Medicare Allowed Amount |
38875.92 |
Total Medicare Payment Amount |
28797.69 |
Total Medicare Standardized Payment Amount |
31347.16 |
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 |
40 |
Number Of Medical Services |
204 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
260718 |
Total Medical Medicare Allowed Amount |
38875.92 |
Total Medical Medicare Payment Amount |
28797.69 |
Total Medical Medicare Standardized Payment Amount |
31347.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
77 |
Number Of Non Hispanic White Beneficiaries |
173 |
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7238 |