National Provider Identifier [NPI]: |
1962419390 |
Last Name Of The Provider |
CUNNINGHAM |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6201 N SUNCOAST BLVD |
Street Address 2 Of The Provider |
C/O SEVEN RIVERS REGIONAL |
City Of The Provider |
CRYSTAL RIVER |
Zip Code Of The Provider |
34428 |
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 |
50 |
Number Of Services |
239 |
Number Of Medicare Beneficiaries |
221 |
Total Submitted Charge Amount |
333334.56 |
Total Medicare Allowed Amount |
74669.08 |
Total Medicare Payment Amount |
58421.77 |
Total Medicare Standardized Payment Amount |
56774.02 |
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 |
50 |
Number Of Medical Services |
239 |
Number Of Medicare Beneficiaries With Medical Services |
221 |
Total Medical Submitted Charge Amount |
333334.56 |
Total Medical Medicare Allowed Amount |
74669.08 |
Total Medical Medicare Payment Amount |
58421.77 |
Total Medical Medicare Standardized Payment Amount |
56774.02 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.1297 |