National Provider Identifier [NPI]: |
1356585194 |
Last Name Of The Provider |
PARTRIGE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 E UNION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENVILLE |
Zip Code Of The Provider |
387033246 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
2 |
Number Of Services |
733 |
Number Of Medicare Beneficiaries |
713 |
Total Submitted Charge Amount |
456380 |
Total Medicare Allowed Amount |
96519.95 |
Total Medicare Payment Amount |
74146.18 |
Total Medicare Standardized Payment Amount |
79605.66 |
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 |
2 |
Number Of Medical Services |
733 |
Number Of Medicare Beneficiaries With Medical Services |
713 |
Total Medical Submitted Charge Amount |
456380 |
Total Medical Medicare Allowed Amount |
96519.95 |
Total Medical Medicare Payment Amount |
74146.18 |
Total Medical Medicare Standardized Payment Amount |
79605.66 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
385 |
Number Of Beneficiaries Age 75 to 84 |
212 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
440 |
Number Of Male Beneficiaries |
273 |
Number Of Non Hispanic White Beneficiaries |
659 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
26 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
625 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0068 |