National Provider Identifier [NPI]: |
1275556359 |
Last Name Of The Provider |
STAPON |
First Name Of The Provider |
THERESA |
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 |
333 ROUTE 25A STE 225 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKY POINT |
Zip Code Of The Provider |
117788802 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
265 |
Number Of Medicare Beneficiaries |
257 |
Total Submitted Charge Amount |
701325 |
Total Medicare Allowed Amount |
36219.33 |
Total Medicare Payment Amount |
28283.9 |
Total Medicare Standardized Payment Amount |
24902 |
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 |
57 |
Number Of Medical Services |
265 |
Number Of Medicare Beneficiaries With Medical Services |
257 |
Total Medical Submitted Charge Amount |
701325 |
Total Medical Medicare Allowed Amount |
36219.33 |
Total Medical Medicare Payment Amount |
28283.9 |
Total Medical Medicare Standardized Payment Amount |
24902 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.618 |