National Provider Identifier [NPI]: |
1366788796 |
Last Name Of The Provider |
STEWART |
First Name Of The Provider |
CHAD |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9601 INTERSTATE 630 |
Street Address 2 Of The Provider |
EXIT 7 |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722057202 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
233 |
Number Of Medicare Beneficiaries |
230 |
Total Submitted Charge Amount |
236096 |
Total Medicare Allowed Amount |
59333.43 |
Total Medicare Payment Amount |
45902 |
Total Medicare Standardized Payment Amount |
49343.71 |
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 |
62 |
Number Of Medical Services |
233 |
Number Of Medicare Beneficiaries With Medical Services |
230 |
Total Medical Submitted Charge Amount |
236096 |
Total Medical Medicare Allowed Amount |
59333.43 |
Total Medical Medicare Payment Amount |
45902 |
Total Medical Medicare Standardized Payment Amount |
49343.71 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
199 |
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 |
192 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6618 |