National Provider Identifier [NPI]: |
1417240193 |
Last Name Of The Provider |
HICKMAN |
First Name Of The Provider |
JOY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
601 E ROLLINS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORLANDO |
Zip Code Of The Provider |
328031248 |
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 |
321 |
Number Of Medicare Beneficiaries |
301 |
Total Submitted Charge Amount |
377332.56 |
Total Medicare Allowed Amount |
62033.6 |
Total Medicare Payment Amount |
47987.96 |
Total Medicare Standardized Payment Amount |
48204.18 |
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 |
321 |
Number Of Medicare Beneficiaries With Medical Services |
301 |
Total Medical Submitted Charge Amount |
377332.56 |
Total Medical Medicare Allowed Amount |
62033.6 |
Total Medical Medicare Payment Amount |
47987.96 |
Total Medical Medicare Standardized Payment Amount |
48204.18 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
125 |
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 |
277 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.023 |