National Provider Identifier [NPI]: |
1750334777 |
Last Name Of The Provider |
KERR |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 JEFFERSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHITEVILLE |
Zip Code Of The Provider |
284723634 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
183 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
193548.76 |
Total Medicare Allowed Amount |
19867.91 |
Total Medicare Payment Amount |
15444.87 |
Total Medicare Standardized Payment Amount |
16005.69 |
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 |
43 |
Number Of Medical Services |
183 |
Number Of Medicare Beneficiaries With Medical Services |
176 |
Total Medical Submitted Charge Amount |
193548.76 |
Total Medical Medicare Allowed Amount |
19867.91 |
Total Medical Medicare Payment Amount |
15444.87 |
Total Medical Medicare Standardized Payment Amount |
16005.69 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
114 |
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 |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0138 |