National Provider Identifier [NPI]: |
1255447223 |
Last Name Of The Provider |
DURIK |
First Name Of The Provider |
BAMBI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
909 E MELBOURNE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELBOURNE |
Zip Code Of The Provider |
329015578 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
243 |
Number Of Medicare Beneficiaries |
208 |
Total Submitted Charge Amount |
404267.5 |
Total Medicare Allowed Amount |
41972.05 |
Total Medicare Payment Amount |
32506.34 |
Total Medicare Standardized Payment Amount |
31531.3 |
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 |
28 |
Number Of Medical Services |
243 |
Number Of Medicare Beneficiaries With Medical Services |
208 |
Total Medical Submitted Charge Amount |
404267.5 |
Total Medical Medicare Allowed Amount |
41972.05 |
Total Medical Medicare Payment Amount |
32506.34 |
Total Medical Medicare Standardized Payment Amount |
31531.3 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
189 |
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 |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4503 |