National Provider Identifier [NPI]: |
1881668747 |
Last Name Of The Provider |
GRAHAM |
First Name Of The Provider |
CATHLEEN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1721 FESSLER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ENGLEWOOD |
Zip Code Of The Provider |
342236427 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
574 |
Number Of Medicare Beneficiaries |
451 |
Total Submitted Charge Amount |
573464 |
Total Medicare Allowed Amount |
72504.67 |
Total Medicare Payment Amount |
56804.52 |
Total Medicare Standardized Payment Amount |
54924.08 |
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 |
32 |
Number Of Medical Services |
574 |
Number Of Medicare Beneficiaries With Medical Services |
451 |
Total Medical Submitted Charge Amount |
573464 |
Total Medical Medicare Allowed Amount |
72504.67 |
Total Medical Medicare Payment Amount |
56804.52 |
Total Medical Medicare Standardized Payment Amount |
54924.08 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
251 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
274 |
Number Of Male Beneficiaries |
177 |
Number Of Non Hispanic White Beneficiaries |
422 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
432 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0715 |