National Provider Identifier [NPI]: |
1033194832 |
Last Name Of The Provider |
BRYAN |
First Name Of The Provider |
KATHERINE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8333 N DAVIS HWY |
Street Address 2 Of The Provider |
MEDICAL CENTER CLINIC |
City Of The Provider |
PENSACOLA |
Zip Code Of The Provider |
32514 |
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 |
17 |
Number Of Services |
530 |
Number Of Medicare Beneficiaries |
518 |
Total Submitted Charge Amount |
286020 |
Total Medicare Allowed Amount |
67734.14 |
Total Medicare Payment Amount |
52549.78 |
Total Medicare Standardized Payment Amount |
51287.35 |
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 |
17 |
Number Of Medical Services |
530 |
Number Of Medicare Beneficiaries With Medical Services |
518 |
Total Medical Submitted Charge Amount |
286020 |
Total Medical Medicare Allowed Amount |
67734.14 |
Total Medical Medicare Payment Amount |
52549.78 |
Total Medical Medicare Standardized Payment Amount |
51287.35 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
303 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
440 |
Number Of Black or African American Beneficiaries |
63 |
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 |
457 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9952 |