National Provider Identifier [NPI]: |
1477647402 |
Last Name Of The Provider |
AARON |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2501 PARKERS LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALEXANDRIA |
Zip Code Of The Provider |
223063209 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
224 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
155347.75 |
Total Medicare Allowed Amount |
39115.57 |
Total Medicare Payment Amount |
30567.53 |
Total Medicare Standardized Payment Amount |
28279.18 |
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 |
33 |
Number Of Medical Services |
224 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
155347.75 |
Total Medical Medicare Allowed Amount |
39115.57 |
Total Medical Medicare Payment Amount |
30567.53 |
Total Medical Medicare Standardized Payment Amount |
28279.18 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
177 |
Number Of Black or African American Beneficiaries |
25 |
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 |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0216 |