National Provider Identifier [NPI]: |
1861743684 |
Last Name Of The Provider |
DARKE |
First Name Of The Provider |
RIKI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18697 BAGLEY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIDDLEBURG HEIGHTS |
Zip Code Of The Provider |
441303417 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
219 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
265982.99 |
Total Medicare Allowed Amount |
26068.68 |
Total Medicare Payment Amount |
20417.82 |
Total Medicare Standardized Payment Amount |
20498.96 |
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 |
53 |
Number Of Medical Services |
219 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
265982.99 |
Total Medical Medicare Allowed Amount |
26068.68 |
Total Medical Medicare Payment Amount |
20417.82 |
Total Medical Medicare Standardized Payment Amount |
20498.96 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
83 |
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 |
169 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4437 |