National Provider Identifier [NPI]: |
1215953401 |
Last Name Of The Provider |
MARWEG |
First Name Of The Provider |
MELANIE |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
830 SOUTH GLOSTER |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUPELO |
Zip Code Of The Provider |
38801 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
413 |
Number Of Medicare Beneficiaries |
358 |
Total Submitted Charge Amount |
308320 |
Total Medicare Allowed Amount |
69403.57 |
Total Medicare Payment Amount |
53476.59 |
Total Medicare Standardized Payment Amount |
56389.17 |
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 |
20 |
Number Of Medical Services |
413 |
Number Of Medicare Beneficiaries With Medical Services |
358 |
Total Medical Submitted Charge Amount |
308320 |
Total Medical Medicare Allowed Amount |
69403.57 |
Total Medical Medicare Payment Amount |
53476.59 |
Total Medical Medicare Standardized Payment Amount |
56389.17 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
316 |
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 |
279 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9282 |