National Provider Identifier [NPI]: |
1932346277 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
TOMARRAH |
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 |
110 29TH AVE N STE 202 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372031448 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
140 |
Number Of Medicare Beneficiaries |
135 |
Total Submitted Charge Amount |
84961.5 |
Total Medicare Allowed Amount |
23742.03 |
Total Medicare Payment Amount |
18607.2 |
Total Medicare Standardized Payment Amount |
19346.58 |
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 |
31 |
Number Of Medical Services |
140 |
Number Of Medicare Beneficiaries With Medical Services |
135 |
Total Medical Submitted Charge Amount |
84961.5 |
Total Medical Medicare Allowed Amount |
23742.03 |
Total Medical Medicare Payment Amount |
18607.2 |
Total Medical Medicare Standardized Payment Amount |
19346.58 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
51 |
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 |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3387 |