National Provider Identifier [NPI]: |
1699725473 |
Last Name Of The Provider |
BRASCHO |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 E 10TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANNISTON |
Zip Code Of The Provider |
362074716 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
234 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
129300 |
Total Medicare Allowed Amount |
24009.81 |
Total Medicare Payment Amount |
18652.01 |
Total Medicare Standardized Payment Amount |
19929.44 |
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 |
57 |
Number Of Medical Services |
234 |
Number Of Medicare Beneficiaries With Medical Services |
228 |
Total Medical Submitted Charge Amount |
129300 |
Total Medical Medicare Allowed Amount |
24009.81 |
Total Medical Medicare Payment Amount |
18652.01 |
Total Medical Medicare Standardized Payment Amount |
19929.44 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
198 |
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
31 |
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 |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5996 |