National Provider Identifier [NPI]: |
1215016860 |
Last Name Of The Provider |
COX |
First Name Of The Provider |
DEBBIE |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
132 HILLCREST DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLARKSVILLE |
Zip Code Of The Provider |
370435000 |
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 |
23 |
Number Of Services |
3307 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
604948 |
Total Medicare Allowed Amount |
223212.05 |
Total Medicare Payment Amount |
166626.61 |
Total Medicare Standardized Payment Amount |
121425.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
2044 |
Number Of Medicare Beneficiaries With Drug Services |
224 |
Total Drug Submitted ChargeAmount |
53295 |
Total Drug Medicare AllowedAmount |
12732.79 |
Total Drug Medicare PaymentAmount |
9516.93 |
Total Drug Medicare Standardized Payment Amount |
9516.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
1263 |
Number Of Medicare Beneficiaries With Medical Services |
227 |
Total Medical Submitted Charge Amount |
551653 |
Total Medical Medicare Allowed Amount |
210479.26 |
Total Medical Medicare Payment Amount |
157109.68 |
Total Medical Medicare Standardized Payment Amount |
111908.51 |
Average Age Of Beneficiaries |
54 |
Number Of Beneficiaries Age Less65 |
191 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
111 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
206 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3417 |