National Provider Identifier [NPI]: |
1720254766 |
Last Name Of The Provider |
LEDDEN |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
225 E JACKSON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
JONESBORO |
Zip Code Of The Provider |
724013119 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
222 |
Number Of Medicare Beneficiaries |
210 |
Total Submitted Charge Amount |
147300 |
Total Medicare Allowed Amount |
55674 |
Total Medicare Payment Amount |
42472.98 |
Total Medicare Standardized Payment Amount |
45924.96 |
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 |
56 |
Number Of Medical Services |
222 |
Number Of Medicare Beneficiaries With Medical Services |
210 |
Total Medical Submitted Charge Amount |
147300 |
Total Medical Medicare Allowed Amount |
55674 |
Total Medical Medicare Payment Amount |
42472.98 |
Total Medical Medicare Standardized Payment Amount |
45924.96 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
195 |
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 |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5001 |