National Provider Identifier [NPI]: |
1033139225 |
Last Name Of The Provider |
BERES |
First Name Of The Provider |
KIMBERLY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
C.R.N.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4150 V STREET, PSSB STE 1200 |
Street Address 2 Of The Provider |
DEPT OF ANESTHESIOLOGY AND PAIN MEDICINE |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958171460 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
151 |
Number Of Medicare Beneficiaries |
149 |
Total Submitted Charge Amount |
246600 |
Total Medicare Allowed Amount |
21349.96 |
Total Medicare Payment Amount |
16075.31 |
Total Medicare Standardized Payment Amount |
16079.78 |
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 |
36 |
Number Of Medical Services |
151 |
Number Of Medicare Beneficiaries With Medical Services |
149 |
Total Medical Submitted Charge Amount |
246600 |
Total Medical Medicare Allowed Amount |
21349.96 |
Total Medical Medicare Payment Amount |
16075.31 |
Total Medical Medicare Standardized Payment Amount |
16079.78 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
106 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
109 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3713 |